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@ARTICLE{Rippke:267532,
author = {C. Rippke and C. K. Renkamp and C. Stahl-Arnsberger$^*$ and
A. Miltner$^*$ and C. Buchele and J. Hörner-Rieber$^*$ and
J. Ristau and J. Debus$^*$ and M. Alber and S. Klüter},
title = {{A} body mass index-based method for '{MR}-only' abdominal
{MR}-guided adaptive radiotherapy.},
journal = {Zeitschrift für medizinische Physik},
volume = {34},
number = {3},
issn = {0939-3889},
address = {Amsterdam},
publisher = {Elsevier, Urban $\&$ Fischer},
reportid = {DKFZ-2023-00310},
pages = {456-467},
year = {2024},
note = {2024 Aug;34(3):456-467},
abstract = {Dose calculation for MR-guided radiotherapy (MRgRT) at the
0.35 T MR-Linac is currently based on deformation of
planning CTs (defCT) acquired for each patient. We present a
simple and robust bulk density overwrite synthetic CT (sCT)
method for abdominal treatments in order to streamline
clinical workflows.Fifty-six abdominal patient treatment
plans were retrospectively evaluated. All patients had been
treated at the MR-Linac using MR datasets for treatment
planning and plan adaption and defCT for dose calculation.
Bulk density CTs (4M-sCT) were generated from MR images with
four material compartments (bone, lung, air, soft tissue).
The relative electron densities (RED) for bone and lung were
extracted from contoured CT structure average REDs. For soft
tissue, a correlation between BMI and RED was evaluated.
Dose was recalculated on 4M-sCT and compared to dose
distributions on defCTs assessing dose differences in the
PTV and organs at risk (OAR).Mean RED of bone was 1.17 ±
0.02, mean RED of lung 0.17 ± 0.05. The correlation between
BMI and RED for soft tissue was statistically significant (p
< 0.01). PTV dose differences between 4M-sCT and defCT were
Dmean: -0.4 ± $1.0\%,$ $D1\%:$ -0.3 ± $1.1\%$ and $D95\%:$
-0.5 ± $1.0\%.$ OARs showed $D2\%:$ -0.3 ± $1.9\%$ and
Dmean: -0.1 ± $1.4\%$ differences. Local 3D gamma index
pass rates $(2\%/2mm)$ between dose calculated using 4M-sCT
and defCT were 96.8 ± $2.6\%$ (range $89.9-99.6\%).The$
presented method for sCT generation enables precise dose
calculation for MR-only abdominal MRgRT.},
keywords = {Adaptive radiotherapy (Other) / Bulk density (Other) /
Image guided radiotherapy (Other) / MR guided radiotherapy
(Other) / MR-only (Other) / Synthetic CT (Other)},
cin = {E050 / HD01},
ddc = {610},
cid = {I:(DE-He78)E050-20160331 / I:(DE-He78)HD01-20160331},
pnm = {315 - Bildgebung und Radioonkologie (POF4-315)},
pid = {G:(DE-HGF)POF4-315},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:36759229},
doi = {10.1016/j.zemedi.2022.12.001},
url = {https://inrepo02.dkfz.de/record/267532},
}