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Translation of dynamic contrast-enhanced imaging onto a magnetic resonance-guided linear accelerator in patients with head and neck cancer
Dubec, M. J. Berks, M. Price, J. McDaid, L. Gaffney, J. Little, R. A. Cheung, S. van Herk, M. Choudhury, A. Matthews, J. C.
Dubec, M. J.
Berks, M.
Price, J.
McDaid, L.
Gaffney, J.
Little, R. A.
Cheung, S.
van Herk, M.
Choudhury, A.
Matthews, J. C.
Abstract
BACKGROUND AND PURPOSE: Magnetic resonance imaging - linear accelerator (MRI-linac) systems permit imaging of tumours to guide treatment. Dynamic contrast enhanced (DCE)-MRI allows investigation of tumour perfusion. We assessed the feasibility of performing DCE-MRI on a 1.5 T MRI-linac in patients with head and neck cancer (HNC) and measured biomarker repeatability and sensitivity to radiotherapy effects. MATERIALS AND METHODS: Patients were imaged on a 1.5 T MRI-linac or a 1.5 T diagnostic MR system twice before treatment. DCE-MRI parameters including K(trans) were calculated, with the optimum pharmacokinetic model identified using corrected Akaike information criterion. Repeatability was assessed by within-subject coefficient of variation (wCV). Treatment effects were assessed as change measured at week 2 of radiotherapy. RESULTS: 14 patients were recruited (6 scanned on diagnostic MR and 8 on MRI-linac), with a total of 24 lesions. Baseline K(trans) estimates were comparable on both MR systems; 0.13 [95 %CI: 0.10 to 0.16] min(-1) (diagnostic MR) and 0.15 [0.12 to 0.18] min(-1) (MRI-linac). wCV values were 22.6 % [95 % CI: 16.2 to 37.3 %] (diagnostic MR) and 11.7 % [8.4 to 19.3 %] (MRI-linac). Combined cohort increase in K(trans) was significant (p < 0.01). Similar results were seen for other DCE-MRI parameters. CONCLUSIONS: DCE-MRI is feasible on a 1.5 T MRI-linac system in patients with HNC. Parameter estimates, repeatability, and sensitivity to treatment were similar to those measured on a conventional diagnostic MR system. These data support performing DCE-MRI in studies on the MRI-linac to assess treatment response and adaptive guidance based on tumour perfusion.
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Date
2025
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Article
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Dubec MJ, Berks M, Price J, McDaid L, Gaffney J, Little RA, et al. Translation of dynamic contrast-enhanced imaging onto a magnetic resonance-guided linear accelerator in patients with head and neck cancer. Physics and imaging in radiation oncology. 2025 Jan;33:100689. PubMed PMID: 39802650. Pubmed Central PMCID: PMC11721217. Epub 2025/01/13. eng.