Abstract
Aims and background: we evaluate CT-3Tesla MRI fusion in conformal radiotherapy for localized prostate cancer.Methods: 18 consecutive patients underwent a 3T MRI scan under radiotherapy planning conditions, after the CT scan. Bowel and bladder preparation were prescribed. CT and MR images were automatically fused; prostate and seminal vesicles were contoured on CT and on MRI, organs at risk were defined on CT-MRI fusion. Late rectal and sexual toxicity, differences in target volume between MRI and CT and differences in rectal and penile bulb dose distribution based on CT only or on CT-MRI fusion were evaluated.Results: one patient experienced a late rectal toxicity; no patient had sexual toxicity. The difference between the mean MRI and CT target volumes was statistically significant (p = 0.0001 paired Student's t-test). The dose-volume histogram (DVH) analysis shows a significant reduction of the dose received by the rectum and the penile bulb in MRI-plans compared to CT-plans.Conclusions: 3 Tesla MRI scan under radiotherapy planning conditions along with bowel preparation significantly improves the definition of the target volume sparing normal tissue irradiation.
Highlights
Prostate cancer is the most common male malignancy in Western countries and the second leading cause of cancer death in men [1,2]
The dose-volume histogram (DVH) analysis shows a significant reduction of the dose received by the rectum and the penile bulb in magnetic resonance imaging (MRI)-plans compared to Computed tomography (CT)-plans.Conclusions: 3 Tesla MRI scan under radiotherapy planning conditions along with bowel preparation significantly improves the definition of the target volume sparing normal tissue irradiation
As concerns target volume analysis we considered the prostate and seminal vesicles (CTV1), being CTV2 included in CTV1
Summary
Prostate cancer is the most common male malignancy in Western countries and the second leading cause of cancer death in men [1,2]. The improvement of the screening has lead to the identification of prostate cancer at an earlier and potentially treatable stage and three dimensional conformal radiation therapy (3DCRT), along with surgery and brachytherapy, are the standard therapies for localized prostate cancer [3,4,5,6,7,8]. Computed tomography (CT) scanning is the most common approach to localize the prostate in radical conformal radiotherapy, but it has poorer soft-tissue contrast than magnetic resonance imaging (MRI), in particular when differentiating the prostate gland from the periprostatic soft tissues. In this study we retrospectively evaluated 3DCRT based on CT-3Tesla MR image fusion, for 18 patients with localized prostate cancer. Differences in CTV (prostate + seminal vesicles) volume between MRI and CT and differences in terms of rectal and penile bulb dose distribution based on CT only or CT-MRI fusion were evaluated as well as late rectal and sexual toxicity
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