K. Kagawa et al., INITIAL CLINICAL-ASSESSMENT OF CT-MRI IMAGE FUSION SOFTWARE IN LOCALIZATION OF THE PROSTATE FOR 3D CONFORMAL RADIATION-THERAPY, International journal of radiation oncology, biology, physics, 38(2), 1997, pp. 319-325
Citations number
15
Categorie Soggetti
Oncology,"Radiology,Nuclear Medicine & Medical Imaging
Purpose: To assess the utility of image fusion software and compare MR
T prostate localization with CT localization in patients undergoing 3D
conformal radiation therapy of prostate cancer. Materials and Methods
: After a phantom study was performed to ensure the accuracy of image
fusion procedure, 22 prostate cancer patients had CT and MRI studies b
efore the start of radiotherapy. Immobilization casts used during radi
ation treatment were also used for both imaging studies. After the cli
nical target volume (CTV) (prostate or prostate + seminal vesicles) wa
s defined on CT, slices from the MRI study were reconstructed to preci
sely match the CT slices by identifying three common bony landmarks on
each study. The CTV was separately defined on the matched MRI slices.
Data related to the size and location of the prostate were compared b
etween CT and MRI. The spatial relationship between the tip of urethro
gram cone on CT and prostate apex seen on MRI was also estimated. Resu
lts: The phantom study showed the registration discrepancies between C
T and MRI smaller than 1.0 mm in any pair in comparison. The patient s
tudy showed a mean image registration error of 0.9 (+/-0.6) mm. The av
erage prostate volume was 63.0 (+/-25.8) cm(3) and 50.9 (+/-22.9) cm(3
) determined by CT and MRT, respectively. The difference in prostate l
ocation with the two studies usually differed at the base and at the a
pex of the prostate. On the transverse MRT, the prostate apex was situ
ated 7.1 (+/-4.5) mm dorsal and 15.1 (+/-4.0) mm cephalad to the tip o
f urethrogram cone. Conclusions: CT-MRI image fusion study made it pos
sible to compare the two modalities directly. MRI localization of the
prostate is more accurate than CT, and indicates the distance from con
e to apex is 15 mm. CT-MRI image fusion technique provides valuable su
pplements to CT technology for more precise targeting of the prostate
cancer. (C) 1997 Elsevier Science Inc.