ANALYSIS OF VASCULAR AND CIRCULAR BLOOD IN RADIATION TREATMENT PLANNING: TECHNOLOGICAL OPTIONS
ROSA MARIA MEIRIÑO,
Spain
PO-1885
Abstract
ANALYSIS OF VASCULAR AND CIRCULAR BLOOD IN RADIATION TREATMENT PLANNING: TECHNOLOGICAL OPTIONS
Authors: ROSA MARIA MEIRIÑO1, Felipe Calvo Manuel1, Javier Burguete2, Javier Serrano Andreu1, Javier Aristu1, Diego Azcona3, Mauricio Cambeiro1, Marta Vidorreta4, Javier Pascau5, Jose Miguel Delgado3, Alberto Alonso6
1Clínica Universidad de Navarra, Oncología Radioterápica, Madrid, Spain; 2Universidad de Navarra, Departamento de Matemática y Física Aplicada, Pamplona, Spain; 3Clínica Universidad de Navarra, Radiofísica Hospitalaria, Madrid, Spain; 4Siemens Healthcare, MR Clinical Scientist, Madrid, Spain; 5Universidad Carlos III, Ingeniería Biomédica, Madrid, Spain; 6Clínica Universidad de Navarra, Radiología, Madrid, Spain
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Purpose or Objective
Evaluate the
possibility of implementing segmentation the vascular tree in treatment
planning of Radiotherapy using new imaging methods such as CT-Body perfusion
that allows visualization and segmentation of the arterial vessels or the MRI
-4D Flow sequences that allow the quantification of vascular blood.
Material and Methods
CT-Body Perfusion
Between April 2019 and
March 2020, 20 patients treated with a radiotherapy component underwent
CT-Body-Perfusion, acquiring multiple series, in order to obtain images of the
arterial and venous phases after a 1st bolus of contrast. A second static CT is
performed after the administration of a second bolus of slow contrast to
visualize the entire vascular tree.
MRI-4D flow
Between March 2021 and
July 2021 in 31 patients treated with a radiotherapy component, series of
MRI-4D flow images were performed in the context of treatment planning in order
to visualize the entire vascular tree, to avoid artifacts in the images are the
product of the patient's breathing, gating techniques have been used in the
thoracic and abdominal locations.
Processing was
performed using the SyngoVia system in the CT body perfusion module or
MM-reading. Reconstruction of the sequences were exported to RayStation TPS for
vessels automatic segmentation.
Results
CT-Body Perfusion
Approximately 27 to 40
in total series are made in each study with Image sequences every 1.5 seconds. The
proportion of supra-infradiaphragmatic locations was 60/40.
The exam requires an
approximate time of 20 to 30 minutes.
MRI-4D flow
As a result of
acquiring 4D flow images, 2 different types of images are obtained, an anatomical
image and a velocity-coded image. The temporal resolution of 41-54 ms, the
spatial resolution of 1-1.7 mm3 and VENC = 20-70 cm/s. Approximately 150 slices
are made in each series. The supra-infradiaphragmatic ratio was 62/38.
Adding the 4D flow
sequence to the clinical protocol increases the scan time by 10-20 minutes.
Conclusion
The inclusion of advanced
imaging techniques would allow the design of vascular structures such as OAR in
Radiotherapy treatments in order to develop strategies to predict and, to a
certain extent, prevent RT-induced vascular and blood damage. MRI's intrinsic sensitivity to
movement offers the unique ability to acquire blood flow simultaneously with
the anatomical data within a single measurement and makes it possible to
implement vascular segmentation without subjecting the patient to greater
exposure to radiation and in a reasonable time.