INTEGRATION/EVALUATION--MRI-ASSISTED TREATMENT PLANNING

本研究的具体目的是确定新出现的作用， 放射治疗中的磁共振成像（MRI） （1）确定其有效性的要求; 使用通过完善其整合成一个完整的3- 三维交互式计算机化治疗计划系统， 2）通过评估其相对有用性， 其添加对最新技术水平的CT辅助治疗的影响 布局 这项研究的结果将导致确定 MRI在RTTP中的临床实用性和成本效益。 研究的第一部分将进一步完善工具， 为了定量地利用 MRI提供的诊断信息。 提出 增强涉及CT和MRI数据的整合，例如： 自动质量保证，定义和校正三维 失真，图像的显示和精确的空间匹配，视觉 和肿瘤范围的定量检测;所有这些都具有 除了RTTP之外，还有更多的意义和实用性。 定期测试和 （自动化）解释应大大提高可靠性 以及所有CT和MRI研究的最终质量。 类似地， 表征肿瘤及其最佳范围的能力将有助于 诊断和选择适当的治疗。 真三维 图像数据的匹配和展开最终可以有助于 减影和分析的后续或定期成像， 检测癌症和其他异常。 MRI对RTTP的潜在价值将在一系列中进行评估 患者的四个特定部位（脑，头颈部，胸部， 前列腺）加上杂项类别。 这些网站提供了一个 技术和方法的综合试验场 核磁共振辅助RTTP 每个病人的治疗都将有计划 由一个放射治疗师，一个物理学家和一个 放射学家的输入，使用所有可用的 标准诊断信息，包括X射线定位和 CT扫描。 随后将举行第二次规划会议 利用所有上述信息，加上MRI 数据集，并将生成独立的治疗计划。 CT和CT+ MRI指定体积之间的差异， 将对治疗方案进行比较和分析。 在每个站点中， 增加MRI改变靶体积的程度 计划治疗技术及临床意义 这些差异将得到评估。 这些数据将 分类并与计划变更的原因相关联，因此 提供了MRI在RTTP中临床应用的初步研究。

The specific aim of this study is to define the emerging role of Magnetic Resonance Imaging (MRI) in radiation therapy treatment planning (RTTP) by: 1) identifying requirements for its effective use through refinement of its integration into a fully 3- dimensional interactive computerized treatment planning system, and 2) studying its relative usefulness through evaluation of the effect its addition has on state of the art CT-assisted treatment plans. The results of this study will lead to the determination of the clinical utility and cost-effectiveness of MRI in RTTP. The first part of the study will further refine the tools and methodology necessary in order to quantitatively utilize the diagnostic information available from MRI. Proposed enhancements involve integration of CT and MRI data such as: automated quality assurance, definition and correction for 3-D distortions, display and refined spatial matching of images, visual and quantitative detection of tumor extents; all of which have additional meaning and utility beyond RTTP. Regular testing and (automated) interpretation should greatly improve the reliability and ultimate quality of all CT and MRI studies. Similarly, the ability to characterize tumors and their extent optimally will aid diagnosis and selection of appropriate therapy. True 3-D matching and unwarping of image data may eventually aid in the subtraction and analysis of follow-up or periodic imaging for detection of cancers and other abnormalities. The potential value of MRI for RTTP will be evaluated in a series of patients for four specific sites (brain, head and neck, thorax, prostate) plus a miscellaneous category. These sites present a comprehensive testing ground for the techniques and methodology of MRI-assisted RTTP. Each patient's treatment will be planned by a team consisting of a radiotherapist, a physicist, and a dosimetrist, with input from a radiologist, using all available standard diagnostic information, including x-ray localization and CT scanning. This will be followed by a second planning session utilizing all the above information with the addition of an MRI data set, and an independent treatment plan will be generated. The differences between CT and CT+ MRI designated volumes and treatment plans will be compared and analyzed. In each site, the degree to which the addition of MRI changes the target volume and the planned treatment technique and the clinical significance of those differences, will be assessed. Those data will be categorized and correlated with reasons for plan changes, thus providing a pilot study of MRI's clinical utility in RTTP.