On the Use of Hyperpolarized Helium MRI for Conformal Avoidance Lung Radiotherapy

C.W Hodge; Wolfgang A Tomé; S.B Fain; S.M Bentzen; M.P Mehta

doi:10.1016/j.meddos.2009.09.004

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On the Use of Hyperpolarized Helium MRI for Conformal Avoidance Lung Radiotherapy

Journal article

Peer reviewed

On the Use of Hyperpolarized Helium MRI for Conformal Avoidance Lung Radiotherapy

C.W Hodge, Wolfgang A Tomé, S.B Fain, S.M Bentzen and M.P Mehta

Medical dosimetry : official journal of the American Association of Medical Dosimetrists, Vol.35(4), pp.297-303

2010

DOI: 10.1016/j.meddos.2009.09.004

PMCID: PMC2975877

PMID: 19944585

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Abstract

We wanted to illustrate the feasibility of using hyperpolarized helium magnetic resonance imaging (HPH-MRI) to obtain functional information that may assist in improving conformal avoidance of ventilating lung tissue during thoracic radiotherapy. HPH-MRI images were obtained from a volunteer patient and were first fused with a proton density-weighted (PD w) MRI to provide corresponding anatomic detail; they were then fused with the treatment planning computed tomography scan of a patient from our treatment planning database who possessed equivalent thoracic dimensions. An optimized treatment plan was then generated using the TomoTherapy treatment planning system, designating the HPH-enhancing regions as ventilation volume (VV). A dose-volume histogram compares the dosimetry of the lungs as a paired organ, the VV, and the lungs minus the VV. The clinical consequences of these changes was estimated using a bio-effect model, the parallel architecture model, or the local damage ( f dam ) model. Model parameters were chosen from published studies linking the incidence of grade 3+ pneumonitis, with the dose and volume irradiated. For two hypothetical treatment plans of 60 Gy in 30 fractions delivered to a right upper-lobe lung mass, one using and one ignoring the VV as an avoidance structure, the mean normalized total dose (NTD mean) values for the lung subvolumes were: lungs = 12.5 Gy 3 vs. 13.52 Gy 3, VV = 9.94 Gy 3 vs. 13.95 Gy 3, and lungs minus VV = 16.69 Gy 3 vs. 19.16 Gy 3. Using the f dam values generated from these plans, one would predict a reduction of the incidence of grade 3+ radiation pneumonitis from 12%–4% when compared with a conventionally optimized plan. The use of HPH-MRI to identify ventilated lung subvolumes is feasible and has the potential to be incorporated into conformal avoidance treatment planning paradigms. A prospective clinical study evaluating this imaging technique is being developed.

Functional imaging

Image guidance

Lung cancer

Magnetic resonance imaging

Radiotherapy

Details

Title: Subtitle: On the Use of Hyperpolarized Helium MRI for Conformal Avoidance Lung Radiotherapy
Creators: C.W Hodge - University of Wisconsin–Madison
Wolfgang A Tomé - University of Wisconsin–Madison
S.B Fain - University of Wisconsin–Madison
S.M Bentzen - University of Wisconsin–Madison
M.P Mehta - University of Wisconsin–Madison
Resource Type: Journal article
Publication Details: Medical dosimetry : official journal of the American Association of Medical Dosimetrists, Vol.35(4), pp.297-303
DOI: 10.1016/j.meddos.2009.09.004
PMID: 19944585
PMCID: PMC2975877
NLM abbreviation: Med Dosim
ISSN: 0958-3947
eISSN: 1873-4022
Publisher: Elsevier Inc
Language: English
Date published: 2010
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Radiology; Electrical and Computer Engineering; Health, Sport, and Human Physiology
Record Identifier: 9984274958102771

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