In phantom evaluation of targeting accuracy in MRI-based brain radiosurgery |
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| Institution: | 1. Department of Biomedical, Experimental and Clinical Sciences “Mario Serio”, University of Florence, Italy;2. National Institute of Nuclear Physics, Florence, Italy;3. Medical Physics Unit, AOU Careggi, Florence, Italy;4. Department of Industrial Engineering, University of Florence, Italy;5. CNR-IFAC, Institute of Applied Physics “N. Carrara”, Florence, Italy;1. Institute of Biostructures and Bioimaging, Italian National Research Council, Via T. De Amicis, 95, 80145 Napoli, Italy;2. Department of Advanced Biomedical Sciences, University of Napoli “Federico II”, 80131 Napoli, Italy;3. Department of Electrical Engineering and Information Technology, University of Napoli “Federico II”, 80125 Napoli, Italy;1. Fondazione Policlinico Universitario ‘‘A. Gemelli’’ IRCCS, Roma, Italy;2. Università Cattolica del Sacro Cuore, Rome, Italy;1. Fondazione Policlinico Universitario ‘‘A. Gemelli’’ IRCCS, Italy;2. Università Cattolica del Sacro Cuore, Rome, Italy;1. S.O.C. Fisica Sanitaria Pistoia-Prato, A.U.S.L. Toscana Centro, Italy;2. Bioinformatics Unit, Hospital of Prato, A.U.S.L. Toscana Centro, Italy;3. U.O.C. Fisica Sanitaria, A.O.U. Careggi, Firenze, Italy;4. S.O.S.A. Fisica Sanitaria, A.O.U. Mayer, Firenze, Italy;5. Department of Medical Physics, P.O. S. Filippo Neri, Roma, Italy;6. S.C. Fisica Sanitaria Firenze-Empoli, A.U.S.L. Toscana Centro, Firenze, Italy;7. Servizio di Fisica Medica, A.O.U. Policlinico di Modena, Modena, Italy;8. Fisica Medica, Azienda USL – IRCCS di Reggio Emilia, Reggio Emilia, Italy;9. S.C. Fisica Sanitaria, A.O.U. Perugia, Perugia, Italy;10. Medical Physics Department, Hospital of Trento, APSS, Trento, Italy;11. Fisica Medica ed Alte Tecnologie, A.O. Ospedali Riuniti Marche Nord, Pesaro, Italy;12. Università degli Studi di Firenze, Firenze, Italy;13. U.O. Radioterapia Oncologica e Fisica Sanitaria, I.R.C.C.S. CROB, Rionero in Vulture (PZ), Italy;14. U.O.D. Fisica Sanitaria, A.O.U. Policlinico Umberto I, Roma, Italy;15. U.O. Fisica Sanitaria, U.L.S.S. 2 Marca Trevigiana, Treviso, Italy;p. U.S.C. Fisica Sanitaria, A.O. Papa Giovanni XXIII, Bergamo, Italy;q. U.O.S.D. Fisica Sanitaria Arezzo, A.U.S.L. Toscana Sud Est, Arezzo, Italy;r. S.O.D. Fisica Sanitaria, A.O.U. Ospedali Riuniti di Ancona, Ancona, Italy;s. U.O. Fisica Sanitaria, Ospedale Policlinico San Martino, Genova, Italy;t. Fisica Sanitaria, A.S.S.T. Grande Ospedale Metropolitano Niguarda, Milano, Italy;u. S.O.C. Fisica Sanitaria, A.S.U.I. Udine S. Maria della Misericordia, Udine, Italy;v. S.C. Laboratorio di Fisica Medica e Sistemi Esperti, Istituto Nazionale Tumori Regina Elena, Roma, Italy;w. U.O.C. Fisica Sanitaria, A.S.S.T. Spedali Civili, Brescia, Italy;x. U.O.C. Fisica Sanitaria, A.O.U. Integrata di Verona, Verona, Italy;y. S.C. Fisica Sanitaria, A.S.S.T. Monza, Monza, Italy;z. U.O.C. Fisica Sanitaria Area Nord, A.U.S.L. Toscana Nord Ovest, Lucca, Italy;11. Servizio Aziendale di Fisica Sanitaria, A.S. dell’Alto Adige, Bolzano, Italy;12. U.O.S.D. Fisica Sanitaria, A.S.L. Viterbo, Viterbo, Italy;13. Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy;14. Dipartimento di Fisica e Astronomia, Università di Bologna, Bologna, Italy;15. Università degli Studi di Perugia, Perugia, Italy;16. Unit of Medical Physics, Pisa University Hospital “Azienda Ospedaliero-Universitaria Pisana”, Pisa, Italy;1. Department of Medical Physics – Oncology, Aarhus University Hospital, Aarhus, Denmark;2. Faculty of Informatics & Science, University of Oradea, Oradea, Romania;3. Cancer Research Institute, University of South Australia, Adelaide, Australia;4. Institut Curie, Université PSL, CNRS UMR3347, Inserm U1021, 91400 Orsay, France;5. Department of Medical Physics, Hygeia Hospital, Athens, Greece;6. Health Physics Department, University Hospital, Novara, Italy;1. Radiology, University of Michigan, Ann Arbor, MI, United States;2. Modus Medical Devices Inc., London, ON, CA, Canada;3. Siemens Healthcare GmbH, Erlangen, DE, Germany;4. MR Clinical Science, Philips Healthcare, Best, NL, Netherlands;5. Radiology and Imaging, Hospital for Special Surgery, New York, NY, United States |
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| Abstract: | PurposeTo determine the targeting accuracy of brain radiosurgery when planning procedures employing different MRI and MRI + CT combinations are adopted.Materials and methodA new phantom, the BrainTool, has been designed and realized to test image co-registration and targeting accuracy in a realistic anatomical situation. The phantom was created with a 3D printer and materials that mimic realistic brain MRI and CT contrast using a model extracted from a synthetic MRI study of a human brain. Eight markers distributed within the BrainTool provide for assessment of the accuracy of image registrations while two cavities that host an ionization chamber are used to perform targeting accuracy measurements with an iterative cross-scan method. Two procedures employing 1.5 T MRI-only or a combination of MRI (taken with 1.5 T or 3 T scanners) and CT to carry out Gamma Knife treatments were investigated. As distortions can impact targeting accuracy, MR images were preliminary evaluated to assess image deformation extent using GammaTool phantom.ResultsMR images taken with both scanners showed average and maximum distortion of 0.3 mm and 1 mm respectively. The marker distances in co-registered images resulted below 0.5 mm for both MRI scans. The targeting mismatches obtained were 0.8 mm, 1.0 mm and 1.2 mm for MRI-only and MRI + CT (1,5T and 3 T), respectively.ConclusionsProcedures using a combination of MR and CT images provide targeting accuracies comparable to those of MRI-only procedures. The BrainTool proved to be a suitable tool for carrying out co-registration and targeting accuracy of Gamma Knife brain radiosurgery treatments. |
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| Keywords: | 3D MR image distortion phantom MR/CT imaging quality control Stereotactic radiosurgery accuracy Brain phantom 3D printing |
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