Geometric impact and dose estimation of on-patient placement of a lightweight receiver coil in a clinical magnetic resonance imaging-only radiotherapy workflow for prostate cancer.

Abstract

For pelvic magnetic resonance imaging (MRI)-only radiotherapy the use of receiver coil bridges (CB) is recommended to avoid deformation of the patient. Development in coil technology has enabled lightweight, flexible coils. In this work we evaluate the effects of a lightweight coil in a pelvic MRI-only radiotherapy workflow. Twenty-one patients, referred to prostate MRI-only radiotherapy, were included. Images were acquired with and without CB. Anatomical deformation from the on-patient coil placement was measured in the anterior-posterior (AP) and left-right (LR) direction. The change in signal-to-noise ratio (SNR) was measured in phantom and in vivo.The clinical treatment plan, created on the image with CB, was transferred and recalculated on the image without the CB. Dose metrics for the targets (planning- and clinical target volume) and organs at risks (OAR) were analyzed. There was a statistically significant increase in SNR in-vivo (median 21%, p=0.002) when removing the CB. Anatomical differences after removing the CB in patients were -1.5mm in AP (median change) and+2.5mm in LR direction. Dosimetric differences for the target structures were clinically negligible, but statistically significant. The difference in target mean doses were 0.2% (both p=0.004) of the prescribed dose. No dosimetric differences were observed for the OAR, except for the penile bulb. We concluded that anatomical change and dosimetric differences, originating from scanning without CB were minor. The CB can thereby be removed from the workflow, enabling easier patient positioning and increased SNR when using lightweight coils.