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First published online February 16, 2009
British Journal of Radiology (2009) 82, 497-503
© 2009 British Institute of Radiology
doi: 10.1259/bjr/50709041
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British Journal of Radiology 82 (2009),497-503 ©2009 The British Institute of Radiology

A novel imaging technique for fusion of high-quality immobilised MR images of the head and neck with CT scans for radiotherapy target delineation

G J Webster, MSc 1 J E Kilgallon, PhD 1 K F Ho, FRCRb 2 C G Rowbottom, PhD 1 N J Slevin, MBChB 3 and R I Mackay, PhD 1

1 North Western Medical Physics, Christie Hospital NHS Foundation Trust, Manchester, UK, 2 Academic Department of Radiation Oncology, University of Manchester, UK, 3 Department of Clinical Oncology, Christie Hospital NHS Foundation Trust, Manchester, UK

Correspondence: G J Webster, North Western Medical Physics, Christie Hospital NHS Foundation Trust, Manchester M20 4BX, UK. E-mail: gareth.webster{at}physics.cr.man.ac.uk

Uncertainty and inconsistency are observed in target volume delineation in the head and neck for radiotherapy treatment planning based only on CT imaging. Alternative modalities such as MRI have previously been incorporated into the delineation process to provide additional anatomical information. This work aims to improve on previous studies by combining good image quality with precise patient immobilisation in order to maintain patient position between scans. MR images were acquired using quadrature coils placed over the head and neck while the patient was immobilised in the treatment position using a five-point thermoplastic shell. The MR image and CT images were automatically fused in the Pinnacle treatment planning system using Syntegra software. Image quality, distortion and accuracy of the image registration using patient anatomy were evaluated. Image quality was found to be superior to that acquired using the body coil, while distortion was < 1.0 mm to a radius of 8.7 cm from the scan centre. Image registration accuracy was found to be 2.2 mm (± 0.9 mm) and < 3.0° (n  =  6). A novel MRI technique that combines good image quality with patient immobilization has been developed and is now in clinical use. The scan duration of approximately 15 min has been well tolerated by all patients.






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