Dose accumulation for MR-guided adaptive radiotherapy: From practical considerations to state-of-the-art clinical implementation

Brigid A. McDonald; Cornel Zachiu; John Christodouleas; Mohamed A. Naser; Mark Ruschin; Jan-Jakob Sonke; Daniela Thorwarth; Daniel Létourneau; Neelam Tyagi; Tony Tadic; Jinzhong Yang; X. Allen Li; Uffe Bernchou; Daniel E. Hyer; Jeffrey E. Snyder; Edyta Bubula-Rehm; Clifton D. Fuller; Kristy K. Brock

doi:10.3389/fonc.2022.1086258

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Dose accumulation for MR-guided adaptive radiotherapy: From practical considerations to state-of-the-art clinical implementation

Journal article

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Dose accumulation for MR-guided adaptive radiotherapy: From practical considerations to state-of-the-art clinical implementation

Brigid A. McDonald, Cornel Zachiu, John Christodouleas, Mohamed A. Naser, Mark Ruschin, Jan-Jakob Sonke, Daniela Thorwarth, Daniel Létourneau, Neelam Tyagi, Tony Tadic, …

Frontiers in oncology, Vol.12, 1086258

01/26/2023

DOI: 10.3389/fonc.2022.1086258

PMCID: PMC9909539

PMID: 36776378

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Abstract

MRI-linear accelerator (MR-linac) devices have been introduced into clinical practice in recent years and have enabled MR-guided adaptive radiation therapy (MRgART). However, by accounting for anatomical changes throughout radiation therapy (RT) and delivering different treatment plans at each fraction, adaptive radiation therapy (ART) highlights several challenges in terms of calculating the total delivered dose. Dose accumulation strategies—which typically involve deformable image registration between planning images, deformable dose mapping, and voxel-wise dose summation—can be employed for ART to estimate the delivered dose. In MRgART, plan adaptation on MRI instead of CT necessitates additional considerations in the dose accumulation process because MRI pixel values do not contain the quantitative information used for dose calculation. In this review, we discuss considerations for dose accumulation specific to MRgART and in relation to current MR-linac clinical workflows. We present a general dose accumulation framework for MRgART and discuss relevant quality assurance criteria. Finally, we highlight the clinical importance of dose accumulation in the ART era as well as the possible ways in which dose accumulation can transform clinical practice and improve our ability to deliver personalized RT.

Details

Title: Subtitle: Dose accumulation for MR-guided adaptive radiotherapy: From practical considerations to state-of-the-art clinical implementation
Creators: Brigid A. McDonald - The University of Texas MD Anderson Cancer Center
Cornel Zachiu
John Christodouleas
Mohamed A. Naser
Mark Ruschin
Jan-Jakob Sonke
Daniela Thorwarth
Daniel Létourneau
Neelam Tyagi
Tony Tadic
Jinzhong Yang
X. Allen Li
Uffe Bernchou
Daniel E. Hyer
Jeffrey E. Snyder
Edyta Bubula-Rehm
Clifton D. Fuller
Kristy K. Brock
Resource Type: Journal article
Publication Details: Frontiers in oncology, Vol.12, 1086258
DOI: 10.3389/fonc.2022.1086258
PMID: 36776378
PMCID: PMC9909539
NLM abbreviation: Front Oncol
ISSN: 2234-943X
eISSN: 2234-943X
Grant note: DOI: 10.13039/100000072, name: National Institute of Dental and Craniofacial Research
Language: English
Date published: 01/26/2023
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Radiation Oncology
Record Identifier: 9984363504402771

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