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Applicator visualization using ultrashort echo time MRI for high-dose-rate endorectal brachytherapy.

Roy P J van den Ende ,
Ece Ercan ,
Rick Keesman ,
Ellen M Kerkhof ,
Corrie A M Marijnen ,
Uulke A van der Heide

Abstract

METHODS AND MATERIALS

We used a radial three-dimensional (3D) UTE pulse sequence and acquired images of phantoms and two patients with rectal cancer. We rigidly registered a UTE image and CT scan of an applicator phantom, based on the outline of the applicator. One observer compared channel positions on the UTE image and CT scan in five slices spaced 25 mm apart. To quantify geometric distortions, we scanned a commercial 3D geometric quality assurance phantom and calculated the difference between detected marker positions on the UTE image and corresponding marker positions on two 3D T1-weighted images with opposing readout directions.

CONCLUSIONS

With a UTE sequence, the endorectal applicator and individual channels can be adequately visualized in both phantom and patients. The geometrical fidelity is within an acceptable range.

RESULTS

On the UTE images, there is sufficient contrast to discern the individual channels. The difference in channel positions on the UTE image compared with the CT was on average -0.1 ± 0.1 mm (left-right) and 0.1 ± 0.3 mm (anteroposterior). After rigid registration to the 3D T1-weighted sequences, the residual 95th percentile of the geometric distortion inside a 550-mm-diameter sphere was 1.0 mm (left-right), 0.9 mm (anteroposterior), and 0.9 mm (craniocaudal).

PURPOSE

The individual channels in an endorectal applicator for high-dose-rate endorectal brachytherapy are not visible on standard MRI sequences. The aim of this study was to test whether an ultrashort echo time (UTE) MRI sequence could be used to visualize the individual channels to enable MR-only treatment planning for rectal cancer.

More about this publication

Brachytherapy

Volume 19
Issue nr. 5
Pages 618-623
Publication date 05-08-2020

Full text links

Publisher website (DOI) 10.1016/j.brachy.2020.06.010
Europe PubMed Central 32747144
Pubmed 32747144

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