PURPOSE - To investigate the conversion of prostate cancer radiotherapy (RT) target definition from CT-based planning into an MRI-only-based planning procedure.
METHODS - Using the CT- and MRI-only-based RT planning protocols, 30 prostate cancer patients were imaged in the RT fixation position. Two physicians delineated the prostate in both CT and T2-weighted MRI images. The CT and MRI images were coregistered based on gold seeds and anatomic borders of the prostate. The uncertainty of the coregistration, as well as differences in target volumes and uncertainty of contour delineation were investigated. Conversion of margins and dose constraints from CT- to MRI-only-based treatment planning was assessed.
RESULTS - On average, the uncertainty of image coregistration was 0.4 ± 0.5 mm (one standard deviation, SD), 0.9 ± 0.8 mm and 0.9 ± 0.9 mm in the lateral, anterior-posterior and base-apex direction, respectively. The average ratio of the prostate volume between CT and MRI was 1.20 ± 0.15 (one SD). Compared to the CT-based contours, the MRI-based contours were on average 2-7 mm smaller in the apex, 0-1 mm smaller in the rectal direction and 1-4 mm smaller elsewhere.
CONCLUSIONS - When converting from a CT-based planning procedure to an MRI-based one, the overall planning target volumes (PTV) are prominently reduced only in the apex. The prostate margins and dose constraints can be retained by this conversion.
Strahlenther Onkol. 2015 Jul 14. [Epub ahead of print]
Seppälä T1, Visapää H, Collan J, Kapanen M, Beule A, Kouri M, Tenhunen M, Saarilahti K.
Comprehensive Cancer Center, University of Helsinki and Helsinki University Hospital, POB 180, 00029, Helsinki, Finland