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MRI-only simulation for prostate radiotherapy planning - 1.5T

Case Study
Minn, Heikki, M.D., Ph.D. Turku University Hospital • Finland
Keyrilainen, Jani, Ph.D. Turku University Hospital • Finland

Patient history and treatment strategy

A 77-year-old male with prostate cancer cT3aN0M0, Gleason 8 and PSA 52 µg/L referred to androgen deprivation and radiation therapy with a prescribed dose of 50 Gy to the pelvic lymph node regions and 76 Gy to the prostate.

Planning strategy

Delineation and dose calculation were performed on MR imaging data only.

MR imaging in treatment position

Patient was imaged at Ingenia MR-RT 1.5T using FlexCoverage Anterior Coil in combination with the integrated Posterior Coil. Total scan time MR-only simulation: 13:07 min.

MRI simulation and interpretation

Axial 3D T1W mDIXON FFE in-phase Axial 3D T2W TSE Axial 3D b-FFE marker scan
Axial 3D T1W mDIXON FFE in-phase
Axial 3D T2W TSE
Axial 3D b-FFE marker scan
MRCAT MRCAT-based dose plan DDR-MRCAT
MRCAT-based dose plan

Images were acquired on a Philips Ingenia MR-RT 1.5T using the Anterior coil and the integrated Posterior coil.

The 3D T1W FFE mDIXON sequence provides in-phase, water and fat images in one acquisition.

Target and organs-at-risk are delineated on the 3D T2W TSE images. Sequence is scanned in sagittal direction; reformats into axial and coronal planes are made. Prostate GTV is shown in orange, PTV in purple.

The 3D b-FFE sequence is used by the planner to mark the position of the fiducial markers and contours are transferred to the digitally reconstructed radiographs (DRRs).

Based on the 3D T1W mDIXON images, MR-based density maps (MRCAT) are automatically generated. The VMAT (Volumetric Modulated Arc Therapy) plan is generated based on MRCAT as primary image set.

Results of case studies are not predictive of results of other cases. Results of other cases may vary.

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Mar 6, 2018

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Case Study
Ingenia 1.5T, Ingenia MR-RT
dStream, MR-RT, Oncology

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