Chemical exchange saturation transfer MRI in central nervous system tumours on a 1.5 T MR-Linac

Rachel W. Chan; Liam S. P. Lawrence; Ryan T. Oglesby; Hanbo Chen; James Stewart; Aimee Theriault; Mikki Campbell; Mark Ruschin; Sten Myrehaug; Eshetu G. Atenafu; Brian Keller; Brige Chugh; Scott MacKenzie; Chia-Lin Tseng; Jay Detsky; Pejman J. Maralani; Greg J. Czarnota; Greg J. Stanisz; Arjun Sahgal; Angus Z. Lau

doi:10.1016/j.radonc.2021.07.010

Chemical exchange saturation transfer MRI in central nervous system tumours on a 1.5 T MR-Linac

Rachel W. Chan, Liam S. P. Lawrence, Ryan T. Oglesby, Hanbo Chen, James Stewart, Aimee Theriault, Mikki Campbell, Mark Ruschin, Sten Myrehaug, Eshetu G. Atenafu, Brian Keller, Brige Chugh, Scott MacKenzie, Chia-Lin Tseng, Jay Detsky, Pejman J. Maralani, Greg J. Czarnota, Greg J. Stanisz, Arjun Sahgal, Angus Z. Lau

Western Sydney University

Research output: Contribution to journal › Article › peer-review

16 Citations (Scopus)

Abstract

Purpose: To describe the implementation and initial results of using Chemical Exchange Saturation Transfer (CEST) for monitoring patients with central nervous system (CNS) tumours treated using a 1.5 tesla MR-guided radiotherapy system. Methods: CNS patients were treated with up to 30 fractions (total dose up to 60 Gy) using a 1.5 T Elekta Unity MR-Linac. CEST scans were obtained in 54 subjects at one or more time points during treatment. CEST metrics, including the amide magnetization transfer ratio (MTRAmide), nuclear Overhauser effect (NOE) MTR (MTRNOE) and asymmetry, were quantified in phantoms and CNS patients. The signal was investigated between tumour and white matter, across time, and across disease categories including high- and low-grade tumours. Results: The gross tumour volume (GTV) exhibited lower MTRAmide and MTRNOE and higher asymmetry compared to contralateral normal appearing white matter. Signal changes in the GTV during fractionated radiotherapy were observed. There were differences between high- and low-grade tumours, with higher CEST asymmetry associated with higher grade disease. Conclusion: CEST MRI using a 1.5 T MR-Linac was demonstrated to be feasible for in vivo imaging of CNS tumours. CEST images showed tumour/white-matter contrast, temporal CEST signal changes, and associations with tumour grade. These results show promise for the eventual goal of using metabolic imaging to inform the design of adaptive radiotherapy protocols.

Original language	English
Pages (from-to)	140-149
Number of pages	10
Journal	Radiotherapy and Oncology
Volume	162
DOIs	https://doi.org/10.1016/j.radonc.2021.07.010
Publication status	Published - 2021

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Chan, R. W., Lawrence, L. S. P., Oglesby, R. T., Chen, H., Stewart, J., Theriault, A., Campbell, M., Ruschin, M., Myrehaug, S., Atenafu, E. G., Keller, B., Chugh, B., MacKenzie, S., Tseng, C.-L., Detsky, J., Maralani, P. J., Czarnota, G. J., Stanisz, G. J., Sahgal, A., & Lau, A. Z. (2021). Chemical exchange saturation transfer MRI in central nervous system tumours on a 1.5 T MR-Linac. Radiotherapy and Oncology, 162, 140-149. https://doi.org/10.1016/j.radonc.2021.07.010

@article{b680694e900b4f2bbf432f3bba3512a9,

title = "Chemical exchange saturation transfer MRI in central nervous system tumours on a 1.5 T MR-Linac",

abstract = "Purpose: To describe the implementation and initial results of using Chemical Exchange Saturation Transfer (CEST) for monitoring patients with central nervous system (CNS) tumours treated using a 1.5 tesla MR-guided radiotherapy system. Methods: CNS patients were treated with up to 30 fractions (total dose up to 60 Gy) using a 1.5 T Elekta Unity MR-Linac. CEST scans were obtained in 54 subjects at one or more time points during treatment. CEST metrics, including the amide magnetization transfer ratio (MTRAmide), nuclear Overhauser effect (NOE) MTR (MTRNOE) and asymmetry, were quantified in phantoms and CNS patients. The signal was investigated between tumour and white matter, across time, and across disease categories including high- and low-grade tumours. Results: The gross tumour volume (GTV) exhibited lower MTRAmide and MTRNOE and higher asymmetry compared to contralateral normal appearing white matter. Signal changes in the GTV during fractionated radiotherapy were observed. There were differences between high- and low-grade tumours, with higher CEST asymmetry associated with higher grade disease. Conclusion: CEST MRI using a 1.5 T MR-Linac was demonstrated to be feasible for in vivo imaging of CNS tumours. CEST images showed tumour/white-matter contrast, temporal CEST signal changes, and associations with tumour grade. These results show promise for the eventual goal of using metabolic imaging to inform the design of adaptive radiotherapy protocols.",

author = "Chan, {Rachel W.} and Lawrence, {Liam S. P.} and Oglesby, {Ryan T.} and Hanbo Chen and James Stewart and Aimee Theriault and Mikki Campbell and Mark Ruschin and Sten Myrehaug and Atenafu, {Eshetu G.} and Brian Keller and Brige Chugh and Scott MacKenzie and Chia-Lin Tseng and Jay Detsky and Maralani, {Pejman J.} and Czarnota, {Greg J.} and Stanisz, {Greg J.} and Arjun Sahgal and Lau, {Angus Z.}",

year = "2021",

doi = "10.1016/j.radonc.2021.07.010",

language = "English",

volume = "162",

pages = "140--149",

journal = "Radiotherapy and Oncology",

issn = "0167-8140",

publisher = "Elsevier Ireland ",

}

Chan, RW, Lawrence, LSP, Oglesby, RT, Chen, H, Stewart, J, Theriault, A, Campbell, M, Ruschin, M, Myrehaug, S, Atenafu, EG, Keller, B, Chugh, B, MacKenzie, S, Tseng, C-L, Detsky, J, Maralani, PJ, Czarnota, GJ, Stanisz, GJ, Sahgal, A & Lau, AZ 2021, 'Chemical exchange saturation transfer MRI in central nervous system tumours on a 1.5 T MR-Linac', Radiotherapy and Oncology, vol. 162, pp. 140-149. https://doi.org/10.1016/j.radonc.2021.07.010

TY - JOUR

T1 - Chemical exchange saturation transfer MRI in central nervous system tumours on a 1.5 T MR-Linac

AU - Chan, Rachel W.

AU - Lawrence, Liam S. P.

AU - Oglesby, Ryan T.

AU - Chen, Hanbo

AU - Stewart, James

AU - Theriault, Aimee

AU - Campbell, Mikki

AU - Ruschin, Mark

AU - Myrehaug, Sten

AU - Atenafu, Eshetu G.

AU - Keller, Brian

AU - Chugh, Brige

AU - MacKenzie, Scott

AU - Tseng, Chia-Lin

AU - Detsky, Jay

AU - Maralani, Pejman J.

AU - Czarnota, Greg J.

AU - Stanisz, Greg J.

AU - Sahgal, Arjun

AU - Lau, Angus Z.

PY - 2021

Y1 - 2021

N2 - Purpose: To describe the implementation and initial results of using Chemical Exchange Saturation Transfer (CEST) for monitoring patients with central nervous system (CNS) tumours treated using a 1.5 tesla MR-guided radiotherapy system. Methods: CNS patients were treated with up to 30 fractions (total dose up to 60 Gy) using a 1.5 T Elekta Unity MR-Linac. CEST scans were obtained in 54 subjects at one or more time points during treatment. CEST metrics, including the amide magnetization transfer ratio (MTRAmide), nuclear Overhauser effect (NOE) MTR (MTRNOE) and asymmetry, were quantified in phantoms and CNS patients. The signal was investigated between tumour and white matter, across time, and across disease categories including high- and low-grade tumours. Results: The gross tumour volume (GTV) exhibited lower MTRAmide and MTRNOE and higher asymmetry compared to contralateral normal appearing white matter. Signal changes in the GTV during fractionated radiotherapy were observed. There were differences between high- and low-grade tumours, with higher CEST asymmetry associated with higher grade disease. Conclusion: CEST MRI using a 1.5 T MR-Linac was demonstrated to be feasible for in vivo imaging of CNS tumours. CEST images showed tumour/white-matter contrast, temporal CEST signal changes, and associations with tumour grade. These results show promise for the eventual goal of using metabolic imaging to inform the design of adaptive radiotherapy protocols.

AB - Purpose: To describe the implementation and initial results of using Chemical Exchange Saturation Transfer (CEST) for monitoring patients with central nervous system (CNS) tumours treated using a 1.5 tesla MR-guided radiotherapy system. Methods: CNS patients were treated with up to 30 fractions (total dose up to 60 Gy) using a 1.5 T Elekta Unity MR-Linac. CEST scans were obtained in 54 subjects at one or more time points during treatment. CEST metrics, including the amide magnetization transfer ratio (MTRAmide), nuclear Overhauser effect (NOE) MTR (MTRNOE) and asymmetry, were quantified in phantoms and CNS patients. The signal was investigated between tumour and white matter, across time, and across disease categories including high- and low-grade tumours. Results: The gross tumour volume (GTV) exhibited lower MTRAmide and MTRNOE and higher asymmetry compared to contralateral normal appearing white matter. Signal changes in the GTV during fractionated radiotherapy were observed. There were differences between high- and low-grade tumours, with higher CEST asymmetry associated with higher grade disease. Conclusion: CEST MRI using a 1.5 T MR-Linac was demonstrated to be feasible for in vivo imaging of CNS tumours. CEST images showed tumour/white-matter contrast, temporal CEST signal changes, and associations with tumour grade. These results show promise for the eventual goal of using metabolic imaging to inform the design of adaptive radiotherapy protocols.

UR - https://hdl.handle.net/1959.7/uws:65508

U2 - 10.1016/j.radonc.2021.07.010

DO - 10.1016/j.radonc.2021.07.010

M3 - Article

SN - 0167-8140

VL - 162

SP - 140

EP - 149

JO - Radiotherapy and Oncology

JF - Radiotherapy and Oncology

ER -

Chemical exchange saturation transfer MRI in central nervous system tumours on a 1.5 T MR-Linac

Abstract

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