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First-in-human technique translation of oxygen-enhanced MRI to an MR linac system in patients with head and neck cancer
Dubec, Michael Buckley, David L Berks, Michael Clough, Abigael Gaffney, John Datta, Anubhav McHugh, Damien J Porta, N. Little, Ross A Cheung, Susan
Dubec, Michael
Buckley, David L
Berks, Michael
Clough, Abigael
Gaffney, John
Datta, Anubhav
McHugh, Damien J
Porta, N.
Little, Ross A
Cheung, Susan
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Abstract
Background and purpose: Tumour hypoxia is prognostic in head and neck cancer (HNC), associated with poor loco-regional control, poor survival and treatment resistance. The advent of hybrid MRI - radiotherapy linear accelerator or 'MR Linac' systems - could permit imaging for treatment adaptation based on hypoxic status. We sought to develop oxygen-enhanced MRI (OE-MRI) in HNC and translate the technique onto an MR Linac system.
Materials and methods: MRI sequences were developed in phantoms and 15 healthy participants. Next, 14 HNC patients (with 21 primary or local nodal tumours) were evaluated. Baseline tissue longitudinal relaxation time (T1) was measured alongside the change in 1/T1 (termed ΔR1) between air and oxygen gas breathing phases. We compared results from 1.5 T diagnostic MR and MR Linac systems.
Results: Baseline T1 had excellent repeatability in phantoms, healthy participants and patients on both systems. Cohort nasal concha oxygen-induced ΔR1 significantly increased (p<0.0001) in healthy participants demonstrating OE-MRI feasibility. ΔR1 repeatability coefficients (RC) were 0.023-0.040 s-1 across both MR systems. The tumour ΔR1 RC was 0.013 s-1 and the within-subject coefficient of variation (wCV) was 25% on the diagnostic MR. Tumour ΔR1 RC was 0.020 s-1 and wCV was 33% on the MR Linac. ΔR1 magnitude and time-course trends were similar on both systems.
Conclusion: We demonstrate first-in-human translation of volumetric, dynamic OE-MRI onto an MR Linac system, yielding repeatable hypoxia biomarkers. Data were equivalent on the diagnostic MR and MR Linac systems. OE-MRI has potential to guide future clinical trials of biology guided adaptive radiotherapy.
Authors
Dubec, Michael
Buckley, David L
Berks, Michael
Clough, Abigael
Gaffney, John
Datta, Anubhav
McHugh, Damien J
Porta, N.
Little, Ross A
Cheung, Susan
Hague, Christina
Eccles, Cynthia L
Hoskin, Peter J
Bristow, Robert G
Matthews, J. C.
van Herk, Marcel
Choudhury, Ananya
Parker, Geoff J M
McPartlin, Andrew J
O'Connor, James P B
Buckley, David L
Berks, Michael
Clough, Abigael
Gaffney, John
Datta, Anubhav
McHugh, Damien J
Porta, N.
Little, Ross A
Cheung, Susan
Hague, Christina
Eccles, Cynthia L
Hoskin, Peter J
Bristow, Robert G
Matthews, J. C.
van Herk, Marcel
Choudhury, Ananya
Parker, Geoff J M
McPartlin, Andrew J
O'Connor, James P B
Description
Date
2023
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Keywords
Type
Article
Citation
Dubec MJ, Buckley DL, Berks M, Clough A, Gaffney J, Datta A, et al. First-in-Human Technique Translation of Oxygen-Enhanced MRI to an MR Linac System in Patients with Head and Neck Cancer. Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology. 2023 Mar 2:109592. PubMed PMID: 36870608. Epub 2023/03/05. eng.