Dosimetric investigation of multi-parametric 4D-MRI for radiotherapy in liver cancer

Abstract Background In radiotherapy, inadequate management of organ motion in liver cancer may lead to inadequate delineation accuracy, resulting in the underdosage of target tissues and overdosage of surrounding normal tissues. To investigate the clinical potential of multi-parametric 4D-MRI in the...

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Main Authors: Sha Li, Xianggao Zhu, Haonan Xiao, Weiwei Liu, Yibao Zhang, Jing Cai, Tian Li, Yanye Lu
Format: Article
Language:English
Published: BMC 2025-04-01
Series:Radiation Oncology
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Online Access:https://doi.org/10.1186/s13014-025-02600-3
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author Sha Li
Xianggao Zhu
Haonan Xiao
Weiwei Liu
Yibao Zhang
Jing Cai
Tian Li
Yanye Lu
author_facet Sha Li
Xianggao Zhu
Haonan Xiao
Weiwei Liu
Yibao Zhang
Jing Cai
Tian Li
Yanye Lu
author_sort Sha Li
collection DOAJ
description Abstract Background In radiotherapy, inadequate management of organ motion in liver cancer may lead to inadequate delineation accuracy, resulting in the underdosage of target tissues and overdosage of surrounding normal tissues. To investigate the clinical potential of multi-parametric 4D-MRI in the target delineation and dose accuracy for liver cancer radiotherapy. Methods Twenty patients receiving radiotherapy for liver cancer were enrolled. Each patient underwent contrast-enhanced planning CT (free-breathing), contrast-enhanced T1-weighted (free-breathing), T2-weighted (gated) 3D-MRI, and low-quality 4D-MRI using the time resolved imaging with interleaved stochastic trajectories volumetric interpolated breath-hold examination (TWIST-VIBE) sequence. A dual-supervised deformation estimation model was used to generate a 4D deformable vector field (4D-DVF) from 4D-MRI data, and the prior images were deformed using this 4D-DVF to generate multi-parametric 4D-MRI. Assisted by 3D-MRI and multi-parametric 4D-MRI, target contours were performed on the planning CT, resulting in the generation of Target_3D and Target_4D. Clinical plans, Plan_3D and Plan_4D, were designed based on these contours respectively. To explore the dosimetric variations resulting from different contours without re-optimization, Plan_3D was directly applied to Target_4D, and Plan_4D was applied to Target_3D to generate Plan_3D’ and Plan_4D’ respectively. Target volume, contours, dose-volume histograms (DVHs), conformity index (CI), homogeneity index (HI), maximum and mean dose to organ as risks (OARs) were compared and evaluated. Results Mean volume differences between Target_3D and Target_4D were 2.76 cm3 (standard deviation [SD] 3.42 cm3) in the caudate lobe, 181.54 cm3 (SD 68.50 cm3) in the left hepatic lobe, and 26.08 cm3 (SD 20.52 cm3) in the right hepatic lobe. Mean and SD of CI and HI is 1.02 ± 0.04 and 0.108 ± 0.02 in Plan_3D, 1.02 ± 0.01 and 0.107 ± 0.01 in Plan_4D. There were no statistically significant differences in OAR doses between Plan_3D and Plan_3D’, between Plan_4D and Plan_4D’. However, a statistically significant difference in target dose was observed between Plan_3D and Plan_3D’ (P = 1.47 × 10⁻⁷) and between Plan_4D and Plan_4D’ (P = 0.013). Plan_3D’ meets 100% of the prescription dose covering mean 77.89% (SD 10.13%) of the Targeted_4D volume, while Plan_4D’ covered mean 94.17% (SD 3.12%) of the Targeted_3D volume. Conclusions 3D image-guided target delineation may be more likely to underestimate target volume and compromise dose coverage, suggesting that using multi-parametric 4D-MRI can provide more precise target contours and enhance target dose coverage.
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spelling doaj-art-e7725ff1341b458aa4c90ea94076e7602025-08-20T03:06:50ZengBMCRadiation Oncology1748-717X2025-04-0120111210.1186/s13014-025-02600-3Dosimetric investigation of multi-parametric 4D-MRI for radiotherapy in liver cancerSha Li0Xianggao Zhu1Haonan Xiao2Weiwei Liu3Yibao Zhang4Jing Cai5Tian Li6Yanye Lu7Institute of Medical Technology, Peking University Health Science CenterKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education / Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Beijing Cancer Hospital & InstituteDepartment of Health Technology and Informatics, The Hong Kong Polytechnic UniversityKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education / Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Beijing Cancer Hospital & InstituteInstitute of Medical Technology, Peking University Health Science CenterDepartment of Health Technology and Informatics, The Hong Kong Polytechnic UniversityDepartment of Health Technology and Informatics, The Hong Kong Polytechnic UniversityInstitute of Medical Technology, Peking University Health Science CenterAbstract Background In radiotherapy, inadequate management of organ motion in liver cancer may lead to inadequate delineation accuracy, resulting in the underdosage of target tissues and overdosage of surrounding normal tissues. To investigate the clinical potential of multi-parametric 4D-MRI in the target delineation and dose accuracy for liver cancer radiotherapy. Methods Twenty patients receiving radiotherapy for liver cancer were enrolled. Each patient underwent contrast-enhanced planning CT (free-breathing), contrast-enhanced T1-weighted (free-breathing), T2-weighted (gated) 3D-MRI, and low-quality 4D-MRI using the time resolved imaging with interleaved stochastic trajectories volumetric interpolated breath-hold examination (TWIST-VIBE) sequence. A dual-supervised deformation estimation model was used to generate a 4D deformable vector field (4D-DVF) from 4D-MRI data, and the prior images were deformed using this 4D-DVF to generate multi-parametric 4D-MRI. Assisted by 3D-MRI and multi-parametric 4D-MRI, target contours were performed on the planning CT, resulting in the generation of Target_3D and Target_4D. Clinical plans, Plan_3D and Plan_4D, were designed based on these contours respectively. To explore the dosimetric variations resulting from different contours without re-optimization, Plan_3D was directly applied to Target_4D, and Plan_4D was applied to Target_3D to generate Plan_3D’ and Plan_4D’ respectively. Target volume, contours, dose-volume histograms (DVHs), conformity index (CI), homogeneity index (HI), maximum and mean dose to organ as risks (OARs) were compared and evaluated. Results Mean volume differences between Target_3D and Target_4D were 2.76 cm3 (standard deviation [SD] 3.42 cm3) in the caudate lobe, 181.54 cm3 (SD 68.50 cm3) in the left hepatic lobe, and 26.08 cm3 (SD 20.52 cm3) in the right hepatic lobe. Mean and SD of CI and HI is 1.02 ± 0.04 and 0.108 ± 0.02 in Plan_3D, 1.02 ± 0.01 and 0.107 ± 0.01 in Plan_4D. There were no statistically significant differences in OAR doses between Plan_3D and Plan_3D’, between Plan_4D and Plan_4D’. However, a statistically significant difference in target dose was observed between Plan_3D and Plan_3D’ (P = 1.47 × 10⁻⁷) and between Plan_4D and Plan_4D’ (P = 0.013). Plan_3D’ meets 100% of the prescription dose covering mean 77.89% (SD 10.13%) of the Targeted_4D volume, while Plan_4D’ covered mean 94.17% (SD 3.12%) of the Targeted_3D volume. Conclusions 3D image-guided target delineation may be more likely to underestimate target volume and compromise dose coverage, suggesting that using multi-parametric 4D-MRI can provide more precise target contours and enhance target dose coverage.https://doi.org/10.1186/s13014-025-02600-3Multi-parametric 4D-MRILiver cancerRadiotherapyTarget contouringPlanDDEM
spellingShingle Sha Li
Xianggao Zhu
Haonan Xiao
Weiwei Liu
Yibao Zhang
Jing Cai
Tian Li
Yanye Lu
Dosimetric investigation of multi-parametric 4D-MRI for radiotherapy in liver cancer
Radiation Oncology
Multi-parametric 4D-MRI
Liver cancer
Radiotherapy
Target contouring
Plan
DDEM
title Dosimetric investigation of multi-parametric 4D-MRI for radiotherapy in liver cancer
title_full Dosimetric investigation of multi-parametric 4D-MRI for radiotherapy in liver cancer
title_fullStr Dosimetric investigation of multi-parametric 4D-MRI for radiotherapy in liver cancer
title_full_unstemmed Dosimetric investigation of multi-parametric 4D-MRI for radiotherapy in liver cancer
title_short Dosimetric investigation of multi-parametric 4D-MRI for radiotherapy in liver cancer
title_sort dosimetric investigation of multi parametric 4d mri for radiotherapy in liver cancer
topic Multi-parametric 4D-MRI
Liver cancer
Radiotherapy
Target contouring
Plan
DDEM
url https://doi.org/10.1186/s13014-025-02600-3
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