Exploring the Role of GD-EOB-DTPA (Primovist®) MRI in Liver Stereotactic Body Radiation Therapy Accuracy
Date
2021-06-17
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Liver Stereotactic Body Radiation Therapy (SBRT) is an effective alternative to surgical resection for liver oligometastases. Liver SBRT technique allows for the delivery of total radiation dose in a much smaller number of treatments compared to conventional radiotherapy course. This results in a more efficient patient throughput, thus allowing for better allocation of clinical resources. Liver SBRT technique has become widespread, and there is increasing interest in its expansion to a broader patient population. Currently, liver SBRT still suffers from practice heterogeneities. Specifically, the number of treatments, motion management, and image guidance can vary across cancer centers. Due to this, the delivery accuracy can also vary across different practices of liver SBRT implementation. The Primovist®-enhanced MRI allows for the direct visualization of the radiation deposition region within the liver. Primovist® is a contrast agent with hepatocyte-specific property, resulting in the direct uptake by liver cells. This potentially creates a novel avenue for the geometric delivery accuracy assessment independent of a treatment’s peculiarities. The use of Primovist® MRI in radiotherapy is relatively new. The purpose of the work presented in this thesis is to develop a framework to help embed Primovist® MRI into the liver SBRT workflow to quantify the geometric accuracy of radiation delivery. To help embed Primovist® MRI into the liver SBRT workflow, the deformable image registration approach has been established and validated. We have conducted an extensive analysis of structure-guided deformable image registration with respect to its associated error and assessed its best implementation approach. One of the preventative factors that hampers wider use of Primovist® MRI is the manual requirement of localizing the visualization of radiation delivery. In this work, we have developed a framework to help automate the localization of radiation delivery. We were then able to use the established framework in conjunction with the validated deformable image registration to directly quantify the geometrical accuracy of liver SBRT delivery using Primovist® MRI. Furthermore, we compared the Primovist®-based geometrical accuracy against the interfractional motion. This work has laid the groundwork that will help with the wider adoption of Primovist® MRI in a liver SBRT workflow.
Description
Keywords
SBRT
Citation
Kuznetsova, S. (2021). Exploring the Role of GD-EOB-DTPA (Primovist®) MRI in Liver Stereotactic Body Radiation Therapy Accuracy (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.