Fully Balanced SSFP Without an Endorectal Coil for Postimplant QA of MRI-Assisted Radiosurgery (MARS) of Prostate Cancer: A Prospective Study.

Purpose: To investigate fully balanced steady-state free precession (bSSFP) with optimized acquisition protocols for magnetic resonance imaging (MRI)-based postimplant quality assessment of low-dose-rate (LDR) prostate brachytherapy without an endorectal coil (ERC).Methods and Materials: Seventeen p...

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Published in:International Journal of Radiation Oncology, Biology, Physics Vol. 109; no. 2; pp. 614 - 626
Main Authors: Sanders, Jeremiah W., Venkatesan, Aradhana M., Levitt, Chad A., Bathala, Tharakeswara, Kudchadker, Rajat J., Tang, Chad, Bruno, Teresa L., Starks, Christine, Santiago, Edwin, Wells, Michelle, Weaver, Carl P., Ma, Jingfei, Frank, Steven J.
Format: clinical trial research Journal Article
Published: Pergamon Press - An Imprint of Elsevier Science Feb2021
Online Access:View this record in EBSCOhost
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      jtl: International Journal of Radiation Oncology, Biology, Physics
      issn: 03603016
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      dt: Feb2021
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      pub: Pergamon Press - An Imprint of Elsevier Science
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        147829593
        147829593
        NLM32980498
        147829593
        10.1016/j.ijrobp.2020.09.040
        NLM32980498
        147829593
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        atl: Fully Balanced SSFP Without an Endorectal Coil for Postimplant QA of MRI-Assisted Radiosurgery (MARS) of Prostate Cancer: A Prospective Study.
      aug:
        au:
          Sanders, Jeremiah W.
          Venkatesan, Aradhana M.
          Levitt, Chad A.
          Bathala, Tharakeswara
          Kudchadker, Rajat J.
          Tang, Chad
          Bruno, Teresa L.
          Starks, Christine
          Santiago, Edwin
          Wells, Michelle
          Weaver, Carl P.
          Ma, Jingfei
          Frank, Steven J.
        affil: Department of Imaging Physics, University of Texas MD Anderson Cancer Center, Houston, Texas
      sug:
        subj:
          Prostatic Neoplasms
          Magnetic Resonance Imaging
          Radiosurgery Equipment and Supplies
          Rectum
          Radiotherapy Equipment and Supplies
          Prostatic Neoplasms Radiotherapy
          Male
          Radiation Dosage
          Brachytherapy Equipment and Supplies
          Prospective Studies
          Sensitivity and Specificity
          Human
          Clinical Trials
          Comparative Studies
          Multicenter Studies
          Evaluation Research
          Validation Studies
          Scales
          Ferrans and Powers Quality of Life Index
          Male
      ab: Purpose: To investigate fully balanced steady-state free precession (bSSFP) with optimized acquisition protocols for magnetic resonance imaging (MRI)-based postimplant quality assessment of low-dose-rate (LDR) prostate brachytherapy without an endorectal coil (ERC).Methods and Materials: Seventeen patients at a major academic cancer center who underwent MRI-assisted radiosurgery (MARS) LDR prostate cancer brachytherapy were imaged with moderate, high, or very high spatial resolution fully bSSFP MRIs without using an ERC. Between 1 and 3 signal averages (NEX) were acquired with acceleration factors (R) between 1 and 2, with the goal of keeping scan times between 4 and 6 minutes. Acquisitions with R >1 were reconstructed with parallel imaging and compressed sensing (PICS) algorithms. Radioactive seeds were identified by 3 medical dosimetrists. Additionally, some of the MRI techniques were implemented and tested at a community hospital; 3 patients underwent MARS LDR prostate brachytherapy and were imaged without an ERC.Results: Increasing the in-plane spatial resolution mitigated partial volume artifacts and improved overall seed and seed marker visualization at the expense of reduced signal-to-noise ratio (SNR). The reduced SNR as a result of imaging at higher spatial resolution and without an ERC was partially compensated for by the multi-NEX acquisitions enabled by PICS. Resultant image quality was superior to the current clinical standard. All 3 dosimetrists achieved near-perfect precision and recall for seed identification in the 17 patients. The 3 postimplant MRIs acquired at the community hospital were sufficient to identify 208 out of 211 seeds implanted without reference to computed tomography (CT).Conclusions: Acquiring postimplant prostate brachytherapy MRI without an ERC has several advantages including better patient tolerance, lower costs, higher clinical throughput, and widespread access to precision LDR prostate brachytherapy. This prospective study confirms that the use of an ERC can be circumvented with fully bSSFP and advanced MRI scan techniques in a major academic cancer center and community hospital, potentially enabling postimplant assessment of MARS LDR prostate brachytherapy without CT.
      pubtype: Academic Journal
      doctype:
        clinical trial
        research
        Journal Article
      ougenre: Article
    language: English
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