Scribd
Upload
24 views7 pages

Mri Sim

MRI is increasingly utilized in radiation therapy due to its superior soft tissue imaging capabilities, enhancing treatment planning and monitoring. While CT remains the gold standard for dose calculation, MRI offers advanced sequences like DWI and TOF that improve tumor detection and treatment response evaluation. However, MRI has limitations such as lack of electron density information and longer scan times, necessitating careful integration with CT for optimal results.

Uploaded by

moiad653
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
24 views7 pages

Mri Sim

MRI is increasingly utilized in radiation therapy due to its superior soft tissue imaging capabilities, enhancing treatment planning and monitoring. While CT remains the gold standard for dose calculation, MRI offers advanced sequences like DWI and TOF that improve tumor detection and treatment response evaluation. However, MRI has limitations such as lack of electron density information and longer scan times, necessitating careful integration with CT for optimal results.

Uploaded by

moiad653
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 7

Magnetic Resonance Imaging Simulation

(MRI-SIM) for Radiation Therapy (RT)

Clinical Motivation:
 Discover the Functionality and Advantages of MRI in Radiation Therapy:
MRI is increasingly used in radiation therapy (RT) because of its superior imaging for
soft tissues, making it ideal for many RT applications.
 CT as the Standard Modality for Dose Calculation:
CT remains the gold standard for dose calculation, offering high geometrical accuracy
critical for clinical RT. It provides both morphological information for contouring and
electron density information essential for precise dose calculations.

 MRI’s Growing Role in RT:


MRI's ability to produce different sequences, providing detailed anatomical and
morphological information, is driving its increased use. Key benefits include:

o Better support for target delineation

o Improved identification of structures and organs at risk (OAR)

o Significant contribution to more accurate treatment planning, delivery, and


monitoring
 MRI’s Role in Detecting Tumor Extensions and Soft Tissue Changes:
MRI is particularly valuable for identifying soft tissue tumors and pathological changes
before anatomical changes occur, such as inflammation (edema) in surrounding OARs.

Advanced MRI Sequences for RT:


 Diffusion-Weighted Imaging (DWI):
This sequence can evaluate therapy response earlier, providing insight into treatment
effectiveness.

 Time of Flight Angiography (TOF):


This sequence can be used for AVM delineation with combination of conventional
Angiography.
 MR Diffusion Tractography (DTI):
This sequence can be used for SRS treatment for dose optimization with consideration of
white matter critical bundles.

Applications in Brachytherapy and SRS/SBRT:


Brachytherapy and Stereotactic Radiosurgery (SRS) or Stereotactic Body Radiation Therapy
(SBRT) benefit greatly from MRI’s enhanced visualization, especially for dose painting, where
identifying sub-lesions (e.g., small glandular lesions in prostate cancer) is critical.
Real Stories:
 Dr. M. Jolicoeur, Charles LeMoyne, Quebec, Canada: MRI helps differentiate
between tumors and normal soft tissue, making it ideal for precision planning in
brachytherapy. MRI excels in visualizing:

o Tumors in the pituitary fossa

o Acoustic neuromas and extra-axial tumors

o Residual disease and tumor bed post-surgery

o Intracranial metastases
Key Structures to Protect:
 Brainstem, Spinal Cord, Optic Chiasm must be carefully protected during RT.
MRI Diagnostic Imaging:
 High-resolution scans for lesion detection
 A variety of sequences with different contrasts
 Geometric distortion is tolerated
 Free positioning in imaging
 Arbitrary slice orientation allowed
 Experienced radiographers ensure fast workflows
MRI in RT Planning:
 High-resolution scans are essential for lesion detection
 Requires robust and contrast-consistent sequences
 No tolerance for geometric distortion
 Imaging is performed in treatment positioning
 Axial images are required for treatment planning systems
 Teams with basic MRI imaging skills are involved
 Supportive workflows are necessary due to lower throughput
MRI Zones and Limitations:
MRI environments are divided into four safety zones to protect patients and staff from the strong
magnetic fields and radiofrequency energy.
1. Zone 1:
o Unrestricted access.
o General public area outside the MRI environment (e.g., reception).
2. Zone 2:
o Semi-restricted area.
o Patients are screened for MRI safety in this zone (e.g., changing rooms, waiting
areas).
3. Zone 3:
o Restricted area with controlled access.
o Only MRI personnel are allowed without direct supervision. This zone contains
magnetic fields that pose a hazard to individuals with metal implants or devices.
4. Zone 4:
o Strictly controlled area (the MRI scanner room itself).
o Directly influenced by the strong magnetic field. Only trained staff and properly
screened individuals are allowed entry. Strict safety protocols must be followed to
avoid injury due to the magnetic field and radiofrequency exposure.
 Implants and Devices:
Patients with certain implants, like pacemakers or aneurysm clips, may not be allowed in
the MRI scanner due to magnetic field interference.
 Metal Objects:
All metal objects (e.g., jewelry, watches, and credit cards) must be removed before
entering the MRI environment to avoid potential injury or damage.
 Pregnancy Considerations:
Pregnant patients or staff should follow specific guidelines regarding MRI exposure.

 Lack of Electron Density Information:


Unlike CT, MRI does not provide electron density data necessary for dose calculations.
Combining MRI with CT or using specialized techniques to overcome this limitation is
often required.
 Geometric Distortions:
MRI is prone to distortions, particularly in large field-of-view images, which can affect
treatment planning accuracy. Careful correction and validation of images are essential.
 Longer Scan Times:
MRI typically has longer scan times than CT, which can result in lower patient
throughput and may not be ideal in urgent treatment situations.
 Non-Metallic Compatibility:
Certain metallic implants and devices may limit or entirely prohibit MRI use due to
safety concerns, affecting its applicability for some patients.

MRI is revolutionizing radiation therapy by providing superior soft tissue imaging, advanced
sequences, and enhanced tumor targeting. Explore the benefits of MRI in RT today!
Prepared by:
Mojtaba Barzegar | Associate Medical Physicist

You might also like