Anatomic and dosimetric changes in patients with head and neck cancer treated with an integrated MRI-tri-60Co teletherapy device

Govind Raghavan, Amar U. Kishan, Minsong Cao, Allen M. Chen

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Objective: Prior studies have relied on CT to assess alterations in anatomy among patients undergoing radiation for head and neck cancer. We sought to determine the feasibility of using MRI-based image-guided radiotherapy to quantify these changes and to ascertain their potential dosimetric implications. Methods: 6 patients with head and neck cancer were treated with intensity-modulated radiotherapy (IMRT) on a novel tri-60Co teletherapy system equipped with a 0.35-T MRI (VR, ViewRay Incorporated, Oakwood Village, OH) to 66-70Gy in 33 fractions (fx). Pre-treatment MRIs on Fx 1, 5, 10, 15, 20, 25, 30 and 33 were imported into a contouring interface, where the primary gross tumour volume (GTV) and parotid glands were delineated. The centre of mass (COM) shifts for these structures were assessed relative to Day 1. Dosimetric data were co-registered with the MRIs, and doses to the GTV and parotid glands were assessed. Results: Primary GTVs decreased significantly over the course of IMRT (median % volume loss, 38.7%; range, 29.5-72.0%; p,0.05) at a median rate of 1.2%/ fx (range, 0.92-2.2%/fx). Both the ipsilateral and contralateral parotid glands experienced significant volume loss (p,0.05, for all) and shifted medially during IMRT. Weight loss correlated significantly with parotid gland volume loss and medial COM shift (p,0.05). Conclusion: Integrated on-board MRI can be used to accurately contour and analyze primary GTVs and parotid glands over the course of IMRT. COM shifts and significant volume reductions were observed, confirming the results of prior CT-based exercises.

Original languageEnglish (US)
Article number20160624
JournalBritish Journal of Radiology
Volume89
Issue number1067
DOIs
StatePublished - 2016

Fingerprint

Parotid Gland
Head and Neck Neoplasms
Intensity-Modulated Radiotherapy
Equipment and Supplies
Tumor Burden
Image-Guided Radiotherapy
Weight Loss
Anatomy
Exercise
Radiation

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Anatomic and dosimetric changes in patients with head and neck cancer treated with an integrated MRI-tri-60Co teletherapy device. / Raghavan, Govind; Kishan, Amar U.; Cao, Minsong; Chen, Allen M.

In: British Journal of Radiology, Vol. 89, No. 1067, 20160624, 2016.

Research output: Contribution to journalArticle

@article{3495bf7e8551418e8c5f3e8a4f41d9b6,
title = "Anatomic and dosimetric changes in patients with head and neck cancer treated with an integrated MRI-tri-60Co teletherapy device",
abstract = "Objective: Prior studies have relied on CT to assess alterations in anatomy among patients undergoing radiation for head and neck cancer. We sought to determine the feasibility of using MRI-based image-guided radiotherapy to quantify these changes and to ascertain their potential dosimetric implications. Methods: 6 patients with head and neck cancer were treated with intensity-modulated radiotherapy (IMRT) on a novel tri-60Co teletherapy system equipped with a 0.35-T MRI (VR, ViewRay Incorporated, Oakwood Village, OH) to 66-70Gy in 33 fractions (fx). Pre-treatment MRIs on Fx 1, 5, 10, 15, 20, 25, 30 and 33 were imported into a contouring interface, where the primary gross tumour volume (GTV) and parotid glands were delineated. The centre of mass (COM) shifts for these structures were assessed relative to Day 1. Dosimetric data were co-registered with the MRIs, and doses to the GTV and parotid glands were assessed. Results: Primary GTVs decreased significantly over the course of IMRT (median {\%} volume loss, 38.7{\%}; range, 29.5-72.0{\%}; p,0.05) at a median rate of 1.2{\%}/ fx (range, 0.92-2.2{\%}/fx). Both the ipsilateral and contralateral parotid glands experienced significant volume loss (p,0.05, for all) and shifted medially during IMRT. Weight loss correlated significantly with parotid gland volume loss and medial COM shift (p,0.05). Conclusion: Integrated on-board MRI can be used to accurately contour and analyze primary GTVs and parotid glands over the course of IMRT. COM shifts and significant volume reductions were observed, confirming the results of prior CT-based exercises.",
author = "Govind Raghavan and Kishan, {Amar U.} and Minsong Cao and Chen, {Allen M.}",
year = "2016",
doi = "10.1259/bjr.20160624",
language = "English (US)",
volume = "89",
journal = "British Journal of Radiology",
issn = "0007-1285",
publisher = "British Institute of Radiology",
number = "1067",

}

TY - JOUR

T1 - Anatomic and dosimetric changes in patients with head and neck cancer treated with an integrated MRI-tri-60Co teletherapy device

AU - Raghavan, Govind

AU - Kishan, Amar U.

AU - Cao, Minsong

AU - Chen, Allen M.

PY - 2016

Y1 - 2016

N2 - Objective: Prior studies have relied on CT to assess alterations in anatomy among patients undergoing radiation for head and neck cancer. We sought to determine the feasibility of using MRI-based image-guided radiotherapy to quantify these changes and to ascertain their potential dosimetric implications. Methods: 6 patients with head and neck cancer were treated with intensity-modulated radiotherapy (IMRT) on a novel tri-60Co teletherapy system equipped with a 0.35-T MRI (VR, ViewRay Incorporated, Oakwood Village, OH) to 66-70Gy in 33 fractions (fx). Pre-treatment MRIs on Fx 1, 5, 10, 15, 20, 25, 30 and 33 were imported into a contouring interface, where the primary gross tumour volume (GTV) and parotid glands were delineated. The centre of mass (COM) shifts for these structures were assessed relative to Day 1. Dosimetric data were co-registered with the MRIs, and doses to the GTV and parotid glands were assessed. Results: Primary GTVs decreased significantly over the course of IMRT (median % volume loss, 38.7%; range, 29.5-72.0%; p,0.05) at a median rate of 1.2%/ fx (range, 0.92-2.2%/fx). Both the ipsilateral and contralateral parotid glands experienced significant volume loss (p,0.05, for all) and shifted medially during IMRT. Weight loss correlated significantly with parotid gland volume loss and medial COM shift (p,0.05). Conclusion: Integrated on-board MRI can be used to accurately contour and analyze primary GTVs and parotid glands over the course of IMRT. COM shifts and significant volume reductions were observed, confirming the results of prior CT-based exercises.

AB - Objective: Prior studies have relied on CT to assess alterations in anatomy among patients undergoing radiation for head and neck cancer. We sought to determine the feasibility of using MRI-based image-guided radiotherapy to quantify these changes and to ascertain their potential dosimetric implications. Methods: 6 patients with head and neck cancer were treated with intensity-modulated radiotherapy (IMRT) on a novel tri-60Co teletherapy system equipped with a 0.35-T MRI (VR, ViewRay Incorporated, Oakwood Village, OH) to 66-70Gy in 33 fractions (fx). Pre-treatment MRIs on Fx 1, 5, 10, 15, 20, 25, 30 and 33 were imported into a contouring interface, where the primary gross tumour volume (GTV) and parotid glands were delineated. The centre of mass (COM) shifts for these structures were assessed relative to Day 1. Dosimetric data were co-registered with the MRIs, and doses to the GTV and parotid glands were assessed. Results: Primary GTVs decreased significantly over the course of IMRT (median % volume loss, 38.7%; range, 29.5-72.0%; p,0.05) at a median rate of 1.2%/ fx (range, 0.92-2.2%/fx). Both the ipsilateral and contralateral parotid glands experienced significant volume loss (p,0.05, for all) and shifted medially during IMRT. Weight loss correlated significantly with parotid gland volume loss and medial COM shift (p,0.05). Conclusion: Integrated on-board MRI can be used to accurately contour and analyze primary GTVs and parotid glands over the course of IMRT. COM shifts and significant volume reductions were observed, confirming the results of prior CT-based exercises.

UR - http://www.scopus.com/inward/record.url?scp=84994092043&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84994092043&partnerID=8YFLogxK

U2 - 10.1259/bjr.20160624

DO - 10.1259/bjr.20160624

M3 - Article

AN - SCOPUS:84994092043

VL - 89

JO - British Journal of Radiology

JF - British Journal of Radiology

SN - 0007-1285

IS - 1067

M1 - 20160624

ER -