MRI and dual-energy CT fusion anatomic imaging in Ru-106 ophthalmic brachytherapy |
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Authors: | Efstathios T. Detorakis Kostas Perisinakis Eleni Drakonaki Dimitrios Liakopoulos Antonios Tzedakis Efrosini Papadaki Miltiadis K. Tsilimbaris |
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Affiliation: | 1. Department of Ophthalmology, University Hospital of Heraklion, Crete, Greece;2. Department of Medical Physics, University of Crete, Medical School, Heraklion, Crete, Greece;3. Department of Anatomy, Medical School, European University of Cyprus, Nicosia, Cyprus;4. Department of Medical imaging, University Hospital of Heraklion, Crete, Greece |
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Abstract: | PurposeBrachytherapy with Ru-106 is widely used for the treatment of intraocular tumors, and its efficacy depends on the accuracy of radioactive plaque placement. Ru-106 plaques are MRI incompatible and create severe metal artifacts on conventional CT scans. Dual-energy CT scans (DECT) may be used to suppress such artifacts. This study examines the possibility of creating fusion images from MRI scans (preoperatively) and DECT scans (with the plaque in place) as a tool for confirming the anatomic accuracy of plaque placement.Methods and MaterialsSix patients with intraocular lesions (5 with choroidal melanoma and 1 with a retinal vasoproliferative lesion) were included. Fusion images of preoperative MRI scans and DECT scans with the plaque in place were created with the Demo version of the ImFusion suite (ImFusion GmbH, Munchen Germany). Clearance margins between the tumor and plaque edge in axial, transverse, and coronal planes as well as the elevation of the posterior plaque edge from the sclera were recorded and associated with the location of the lesion.ResultsPlaque-tumor clearance margins for transverse, sagittal, and coronal planes were higher for anteriorly located lesions (5.13 mm ± 0.11 [5.0–5.2], 5.10 mm ± 0.26 [4.9–5.4], and 5.33 mm ± 0.45 [4.9–5.8] respectively) than for posteriorly located lesions (4.16 mm ± 1.44 [2.5–5.1], 4.13 mm ± 1.42 [2.5–5.1], and 4.2 mm ± 1.21 [2.8–5.0], respectively). The elevation of the posterior plaque edge from the sclera was 0.33 mm ± 0.28 [0–0.5] and 0.63 mm ± 0.60 [0.7–1.2] for posterior and anterior lesions, respectively.ConclusionsFusion images between DECT and MRI scans may be used as a tool to confirm the accuracy of Ru-106 plaque placement in relation with the intraocular tumors in ophthalmic brachytherapy. |
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Keywords: | MRI DECT Fusion Ophthalmic brachytherapy Ru-106 Episcleral radioactive plaque Ocular tumors |
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