INTEGRATION/EVALUATION--MRI-ASSISTED TREATMENT PLANNING

这项研究的具体目的是确定 磁共振成像在放射治疗中的应用 规划(RTTP)通过：1)确定其有效性的要求 通过将其集成到完整的3- 立体交互式计算机治疗计划系统， 2)通过对其进行评价，研究其相对有用性 它的加入对最先进的CT辅助治疗的影响 计划。这项研究的结果将导致确定 MRI在RTTP中的临床应用和成本-效果分析。 研究的第一部分将进一步完善工具和 必要的方法以便定量地利用 可从核磁共振获得诊断信息。建议 增强功能涉及CT和MRI数据的集成，例如： 3-D的自动质量保证、定义和校正 图像的扭曲、显示和精细的空间匹配、视觉 和肿瘤范围的定量检测；所有这些都有 RTTP之外的其他含义和用途。定期测试和 (自动)口译应该会大大提高可靠性 以及所有CT和MRI研究的终极质量。类似地， 能够最佳地确定肿瘤的特征及其范围将有助于 诊断和选择合适的治疗方法。真3-D 图像数据的匹配和去扭曲最终可能有助于 随访或周期性影像检查的减影分析 癌症和其他异常的检测。 MRI对RTTP的潜在价值将在一系列评估中进行 患者的四个特定部位(大脑、头部和颈部、胸部、 前列腺癌)外加其他类别。这些网站提供了一个 技术和方法论的综合试验场 MRI辅助的RTTP。每个病人的治疗都会有计划的 由一个由放射治疗师、物理学家和一个 放射科医生提供的信息，使用所有可用的 标准诊断信息，包括X射线定位和 CT扫描。之后将举行第二次规划会议 使用所有上述信息并添加核磁共振成像 数据集，并将生成独立的治疗计划。 CT与CT+MRI的指定体积及大小的差异 治疗方案将进行比较和分析。在每个站点中， 添加MRI改变目标体积的程度 以及计划治疗技术和临床意义 在这些差异中，将进行评估。这些数据将是 对计划变更的原因进行分类并加以关联，从而 为MRI在RTTP中的临床应用提供初步研究。

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.