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Patch-based generation of a pseudo CT from conventional MRI sequences for
MRI-only radiotherapy of the brain
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In radiotherapy (RT) based on magnetic resonance imaging
the only modality, the information on electron density must be derived from the
scan by creating a so-called pseudo computed tomography (pCT). This is a nontrivial
task, since the voxel-intensities in an MRI scan are not uniquely related to electron
density. To solve the task, voxel-based or atlas-based models have typically been
used. The voxel-based models require a specialized dual ultrashort echo time
sequence for bone visualization and the atlas-based models require deformable
registrations of conventional MRI scans. In this study, we investigate the
potential of a patch-based method for creating a pCT based on conventional
1-weighted MRI scans without
using deformable registrations. We compare this method against two
state-of-the-art methods within the voxel-based and atlas-based categories.
The data consisted of CT and MRI scans of five
cranial RT patients. To compare the performance of the different methods, a nested
cross validation was done to find optimal model parameters for all the methods.
Voxel-wise and geometric evaluations of the pCTs were done. Furthermore, a
radiologic evaluation based on water equivalent path lengths was carried out,
comparing the upper hemisphere of the head in the pCT and the real CT. Finally,
the dosimetric accuracy was tested and compared for a
The pCTs produced with the patch-based method had the best voxel-wise, geometric,
and radiologic agreement with the real CT, closely followed by the atlas-based
method. In terms of the dosimetric accuracy, the patch-based method had average
deviations of less than 0.5% in measures related to target coverage.
We showed that a patch-based method could generate an accurate pCT based on
1-weighted MRI sequences and
without deformable registrations. In our evaluations, the method performed better
than existing voxel-based and atlas-based methods and showed a promising potential
for RT of the brain based only on MRI.
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