Evidence map›Paper›PMID 34688037›Full record

ArticleComputers in biology and medicine2021

Synthetic digital reconstructed radiographs for MR-only robotic stereotactic radiation therapy: A proof of concept.

Gregory Szalkowski, Dong Nie, Tong Zhu, Pew-Thian Yap, Jun Lian

Open access · greenAbstract read
In one paragraph

Article in Computers in biology and medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
1.1field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Gregory SzalkowskiDepartment of Radiation Oncology, University of North Carolina, Chapel Hill, NC, USA.
Dong NieDepartment of Radiology and Biomedical Research Imaging Center, University of North Carolina, Chapel Hill, NC, USA.
Tong ZhuDepartment of Radiation Oncology, University of North Carolina, Chapel Hill, NC, USA.
Pew-Thian YapDepartment of Radiology and Biomedical Research Imaging Center, University of North Carolina, Chapel Hill, NC, USA. Electronic address: ptyap@med.unc.edu.
Jun LianDepartment of Radiation Oncology, University of North Carolina, Chapel Hill, NC, USA. Electronic address: jun_lian@med.unc.edu.
University of North Carolina at Chapel Hill · USImaging Center · US

Funding

Automatic Pelvic Organ Delineation in Prostate Cancer TreatmentR01CA206100 · NCI · UNIV OF NORTH CAROLINA CHAPEL HILL · PI LIAN, JUN · 2016 to 2022
$1.7M
NCI NIH HHS R01 CA206100
6 · The paper itself

Abstract

purposeTo create synthetic CTs and digital reconstructed radiographs (DRRs) from MR images that allow for fiducial visualization and accurate dose calculation for MR-only radiosurgery.

methodsWe developed a machine learning model to create synthetic CTs from pelvic MRs for prostate treatments. This model has been previously proven to generate synthetic CTs with accuracy on par or better than alternate methods, such as atlas-based registration. Our dataset consisted of 11 paired CT and conventional MR (T2) images used for previous CyberKnife (Accuray, Inc) radiotherapy treatments. The MR images were pre-processed to mimic the appearance of fiducial-enhancing images. Two models were trained for each parameter case, using a sub-set of the available image pairs, with the remaining images set aside for testing and validation of the model to identify the optimal patch size and number of image pairs used for training. Four models were then trained using the identified parameters and used to generate synthetic CTs, which in turn were used to generate DRRs at angles 45° and 315°, as would be used for a CyberKnife treatment. The synthetic CTs and DRRs were compared visually and using the mean squared error and peak signal-to-noise ratio against the ground-truth images to evaluate their similarity.

resultsThe synthetic CTs, as well as the DRRs generated from them, gave similar visualization of the fiducial markers in the prostate as the true counterparts. There was no significant difference found for the fiducial localization for the CTs and DRRs. Across the 8 DRRs analyzed, the mean MSE between the normalized true and synthetic DRRs was 0.66 ± 0.42% and the mean PSNR for this region was 22.9 ± 3.7 dB. For the full CTs, the mean MAE was 72.9 ± 88.1 HU and the mean PSNR was 31.2 ± 2.2 dB.

conclusionsOur machine learning-based method provides a proof of concept of a way to generate synthetic CTs and DRRs for accurate dose calculation and fiducial localization for use in radiation treatment of the prostate.

Indexed as

RadiosurgeryRobotic Surgical ProceduresHumansImage Processing, Computer-AssistedMagnetic Resonance ImagingMalePelvisRadiotherapy Planning, Computer-AssistedTomography, X-Ray ComputedDeep learningRobotic radiotherapySynthetic CT

Identifiers

PMID34688037
PMCPMC8627784
OpenAlexW3205972014

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.