Tap the real power of MR simulation

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MR-only simulation for prostate

 

Today, MR has even more to offer for radiation treatment planning. Innovative MR-only simulation by Philips helps you rely on MR as a primary imaging modality for prostate cancer treatment planning.

 

Available as a plug-in extension to Ingenia MR-RT, MR-only simulation allows you to adopt a single-modality imaging approach that provides excellent soft-tissue contrast you trust for target delineation - plus density information for dose calculations. Fast scanning protocols and embedded post-processing steps generate MRCAT (MR for Calculating ATtenuation) images on the MR console in just a few minutes with the density information you’d expect from CT.

Dr. Uulke van der Heide describes MR’s changing role in radiotherapy and a recent collaboration with Philips to bring MR-only simulation for RT planning from the lab to clinic. The Philips Ingenia MR-RT platform now supports MR-only simulation for planning the treatment of prostate cancer patients.

 

Prof. Dr. van der Heide is a medical physicist at the Netherlands Cancer Institute in Amsterdam.

Prof. Dr. van der Heide

Challenges in an MR-CT simulation approach

A combined MR-CT approach can benefit radiation treatment planning. In most clinical workflows, MRI-based information on tissue characterization and tumor delineation is registered to a primary CT dataset. This provides the electron density information as input for dose calculations. Yet this method can also put pressure on workflows, patients, and costs. CTMR image registration also introduces uncertainties. Errors in the alignment of MR and CT images series in the treatment preparation stage propagate as a systematic geometric error following the patient throughout the entire treatment period.

The potential of an MR-only simulation workflow

An MR-only simulation workflow can eliminate technical, worfklow and economic challenges related to the MR-CT multimodality imaging workflow for specific tumor types and help you adopt MR for your treatment planning.
Figure 1 shows the current CT & MR workflow for RT treatment planning
Figure 2 shows the workflow with MR-only simulation for RT treatment planning

Fast and automated approach

 

Philips MR-only simulation provides a fast and automated approach to obtain excellent soft-tissue contrast and robust 3D density maps in one MR imaging session.

Step
1

Optimized for fast and robust image acquisition, a dedicated imaging protocol provides a dedicated 3D T1W mDIXON sequence as input for MRCAT generation and a T2W scan to provide the anatomical information for delineation of target and critical structures.

Step

2

MRCAT images with density information are generated fully automatically at the MR console, parallel to image acquisition. Smart, validated algorithms enable automatic tissue characterization of five tissue types; air, fat, water, cortical bone, and spongy bone. Subsequent bulk-density assignment provides MRCAT images with CT-based density information.

Step

3

The MRCAT images conform to DICOM and can be automatically exported, like CT images, to main treatment planning systems. You can use this information as the primary image dataset for dose calculations and to generate MR-based digitally reconstructed radiographs (DRRs).

RTdrive MR prostate

 

Perform prostate dose calculations based on MR-data only

MR sim
MR-sim

T2W

Soft-tissue contrast

Delineation and dose planning

MRCAT

Density information

Delineation and dose planning
Delineation and dose planning
Brochure

Clinical excellence with MR-only simulation

To successfully bring MR-only simulation into your clinical routine, we recognize the need to look beyond MR imaging – and also address steps such as patient marking, position verification, and quality assurance. We can help you successfully adopt this new simulation paradigm with our workflow descriptions and tailored training support for radiation oncology professionals.

MR-only simulation for prostate

Compatibility
Ingenia MR-RT 1.5T and 3.0T
Anatomy supported
Prostate
Imaging protocol

Dedicated ExamCard provides sequences for:

  • 3D MRCAT source information (mDIXON)
  • Anatomical information for delineation (T2W TSE)
  • Prostate marker visualization (FFE 3D/bFFE 3D)
MRCAT generation

Running parallel to image acquisition on the MR console, embedded post-processing generates MRCAT images using:

  • Automated segmentation and tissue classification
  • Automated assignment of CT-based density values
Auto-segmentation
Five different classifications: water, fat, spongy bone, compact bone, and air
Export to treatment planning systems
MRCAT images are DICOM conform (CT) for direct export to treatment planning systems

Radiation Oncology solutions

 

Philips has a proven portfolio of dedicated radiotherapy solutions that span imaging to treatment planning. We help you to address sources of uncertainty and inefficiency with innovations such as industry-leading imaging, scalable and customizable treatment planning, and intelligent workflow automation. And as a committed partner, we help you maximize value and future proof your investments.

1. Tested in a non-clinical environment with single Pinnacle3 user and a 5-beam IMRT plan. Excluding time for optional manual adjustments.