An efficient and robust MRI-guided radiotherapy planning approach for targeting abdominal organs and tumours in the mouse.

<h4>Introduction</h4>Preclinical CT-guided radiotherapy platforms are increasingly used but the CT images are characterized by poor soft tissue contrast. The aim of this study was to develop a robust and accurate method of MRI-guided radiotherapy (MR-IGRT) delivery to abdominal targets i...

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Main Authors: Veerle Kersemans, John S Beech, Stuart Gilchrist, Paul Kinchesh, Philip D Allen, James Thompson, Ana L Gomes, Zenobia D'Costa, Luke Bird, Iain D C Tullis, Robert G Newman, Aurelien Corroyer-Dulmont, Nadia Falzone, Abul Azad, Katherine A Vallis, Owen J Sansom, Ruth J Muschel, Borivoj Vojnovic, Mark A Hill, Emmanouil Fokas, Sean C Smart
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2017-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0176693&type=printable
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author Veerle Kersemans
John S Beech
Stuart Gilchrist
Paul Kinchesh
Philip D Allen
James Thompson
Ana L Gomes
Zenobia D'Costa
Luke Bird
Iain D C Tullis
Robert G Newman
Aurelien Corroyer-Dulmont
Nadia Falzone
Abul Azad
Katherine A Vallis
Owen J Sansom
Ruth J Muschel
Borivoj Vojnovic
Mark A Hill
Emmanouil Fokas
Sean C Smart
author_facet Veerle Kersemans
John S Beech
Stuart Gilchrist
Paul Kinchesh
Philip D Allen
James Thompson
Ana L Gomes
Zenobia D'Costa
Luke Bird
Iain D C Tullis
Robert G Newman
Aurelien Corroyer-Dulmont
Nadia Falzone
Abul Azad
Katherine A Vallis
Owen J Sansom
Ruth J Muschel
Borivoj Vojnovic
Mark A Hill
Emmanouil Fokas
Sean C Smart
author_sort Veerle Kersemans
collection DOAJ
description <h4>Introduction</h4>Preclinical CT-guided radiotherapy platforms are increasingly used but the CT images are characterized by poor soft tissue contrast. The aim of this study was to develop a robust and accurate method of MRI-guided radiotherapy (MR-IGRT) delivery to abdominal targets in the mouse.<h4>Methods</h4>A multimodality cradle was developed for providing subject immobilisation and its performance was evaluated. Whilst CT was still used for dose calculations, target identification was based on MRI. Each step of the radiotherapy planning procedure was validated initially in vitro using BANG gel dosimeters. Subsequently, MR-IGRT of normal adrenal glands with a size-matched collimated beam was performed. Additionally, the SK-N-SH neuroblastoma xenograft model and the transgenic KPC model of pancreatic ductal adenocarcinoma were used to demonstrate the applicability of our methods for the accurate delivery of radiation to CT-invisible abdominal tumours.<h4>Results</h4>The BANG gel phantoms demonstrated a targeting efficiency error of 0.56 ± 0.18 mm. The in vivo stability tests of body motion during MR-IGRT and the associated cradle transfer showed that the residual body movements are within this MR-IGRT targeting error. Accurate MR-IGRT of the normal adrenal glands with a size-matched collimated beam was confirmed by γH2AX staining. Regression in tumour volume was observed almost immediately post MR-IGRT in the neuroblastoma model, further demonstrating accuracy of x-ray delivery. Finally, MR-IGRT in the KPC model facilitated precise contouring and comparison of different treatment plans and radiotherapy dose distributions not only to the intra-abdominal tumour but also to the organs at risk.<h4>Conclusion</h4>This is, to our knowledge, the first study to demonstrate preclinical MR-IGRT in intra-abdominal organs. The proposed MR-IGRT method presents a state-of-the-art solution to enabling robust, accurate and efficient targeting of extracranial organs in the mouse and can operate with a sufficiently high throughput to allow fractionated treatments to be given.
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spelling doaj-art-ae518cca3a5a4ee6a6bf6b30edf910b82025-08-20T02:31:59ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01124e017669310.1371/journal.pone.0176693An efficient and robust MRI-guided radiotherapy planning approach for targeting abdominal organs and tumours in the mouse.Veerle KersemansJohn S BeechStuart GilchristPaul KincheshPhilip D AllenJames ThompsonAna L GomesZenobia D'CostaLuke BirdIain D C TullisRobert G NewmanAurelien Corroyer-DulmontNadia FalzoneAbul AzadKatherine A VallisOwen J SansomRuth J MuschelBorivoj VojnovicMark A HillEmmanouil FokasSean C Smart<h4>Introduction</h4>Preclinical CT-guided radiotherapy platforms are increasingly used but the CT images are characterized by poor soft tissue contrast. The aim of this study was to develop a robust and accurate method of MRI-guided radiotherapy (MR-IGRT) delivery to abdominal targets in the mouse.<h4>Methods</h4>A multimodality cradle was developed for providing subject immobilisation and its performance was evaluated. Whilst CT was still used for dose calculations, target identification was based on MRI. Each step of the radiotherapy planning procedure was validated initially in vitro using BANG gel dosimeters. Subsequently, MR-IGRT of normal adrenal glands with a size-matched collimated beam was performed. Additionally, the SK-N-SH neuroblastoma xenograft model and the transgenic KPC model of pancreatic ductal adenocarcinoma were used to demonstrate the applicability of our methods for the accurate delivery of radiation to CT-invisible abdominal tumours.<h4>Results</h4>The BANG gel phantoms demonstrated a targeting efficiency error of 0.56 ± 0.18 mm. The in vivo stability tests of body motion during MR-IGRT and the associated cradle transfer showed that the residual body movements are within this MR-IGRT targeting error. Accurate MR-IGRT of the normal adrenal glands with a size-matched collimated beam was confirmed by γH2AX staining. Regression in tumour volume was observed almost immediately post MR-IGRT in the neuroblastoma model, further demonstrating accuracy of x-ray delivery. Finally, MR-IGRT in the KPC model facilitated precise contouring and comparison of different treatment plans and radiotherapy dose distributions not only to the intra-abdominal tumour but also to the organs at risk.<h4>Conclusion</h4>This is, to our knowledge, the first study to demonstrate preclinical MR-IGRT in intra-abdominal organs. The proposed MR-IGRT method presents a state-of-the-art solution to enabling robust, accurate and efficient targeting of extracranial organs in the mouse and can operate with a sufficiently high throughput to allow fractionated treatments to be given.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0176693&type=printable
spellingShingle Veerle Kersemans
John S Beech
Stuart Gilchrist
Paul Kinchesh
Philip D Allen
James Thompson
Ana L Gomes
Zenobia D'Costa
Luke Bird
Iain D C Tullis
Robert G Newman
Aurelien Corroyer-Dulmont
Nadia Falzone
Abul Azad
Katherine A Vallis
Owen J Sansom
Ruth J Muschel
Borivoj Vojnovic
Mark A Hill
Emmanouil Fokas
Sean C Smart
An efficient and robust MRI-guided radiotherapy planning approach for targeting abdominal organs and tumours in the mouse.
PLoS ONE
title An efficient and robust MRI-guided radiotherapy planning approach for targeting abdominal organs and tumours in the mouse.
title_full An efficient and robust MRI-guided radiotherapy planning approach for targeting abdominal organs and tumours in the mouse.
title_fullStr An efficient and robust MRI-guided radiotherapy planning approach for targeting abdominal organs and tumours in the mouse.
title_full_unstemmed An efficient and robust MRI-guided radiotherapy planning approach for targeting abdominal organs and tumours in the mouse.
title_short An efficient and robust MRI-guided radiotherapy planning approach for targeting abdominal organs and tumours in the mouse.
title_sort efficient and robust mri guided radiotherapy planning approach for targeting abdominal organs and tumours in the mouse
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0176693&type=printable
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