Evidence map›Paper›PMID 42003063›Full record

ArticleJournal of applied clinical medical physics2026

Quantifying setup uncertainty between computed tomography guidance and magnetic resonance guidance in intramuscular metastases radiotherapy.

Travis Salzillo, Surendra Prajapati, Zhiqian Henry Yu, Yao Zhao, Tze Yee Lim, He Wang, Xin A Wang, Xinru Chen, Rajat Kudchadker, Belinda Lee and 6 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of applied clinical medical physics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. 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

16 authors.

Travis SalzilloDepartment of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.ORCID https://orcid.org/0000-0001-6271-9879
Surendra PrajapatiDepartment of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.ORCID https://orcid.org/0000-0003-3531-8054
Zhiqian Henry YuDepartment of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.ORCID https://orcid.org/0000-0002-2441-4457
Yao ZhaoDepartment of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Tze Yee LimDepartment of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
He WangDepartment of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.ORCID https://orcid.org/0000-0002-4904-531X
Xin A WangDepartment of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Xinru ChenDepartment of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.ORCID https://orcid.org/0000-0002-9989-8943
Rajat KudchadkerDepartment of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Belinda LeeDepartment of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Angela SobremonteDepartment of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Ahsan S FarooqiDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Devarati MitraDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Andrew BishopDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Chad TangDepartment of Genitourinary Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Jinzhong YangDepartment of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.ORCID https://orcid.org/0000-0002-9254-4501

Funding

Tumor Evolution and Metastasis ProgramP30CA016672 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI DIANE BODURKA · 1985 to 2026
$290.8M
National Institutes of Health/National Cancer Institute P30CA016672NCI NIH HHS P30 CA016672
6 · The paper itself

Abstract

background and purposeMR-Linac (MRL) is well-suited for treatment of oligometastatic disease (OMD) in muscle due to its superior soft tissue contrast. The purpose of this study was to assess dosimetric differences and quantify margins when CT-guidance (CTgRT) is used for OMD treatment compared to MR-guidance (MRgRT) on the MRL. MATERIALS AND

methodsFive patients with intramuscular oligometastasis were treated with the MRL using daily MRgRT. To simulate CT-based alignment, an in-house deep learning model was used to generate synthetic-CT images from MR images for each fraction. The synthetic-CTs were independently aligned to the corresponding simulation-CTs by seven physicists using rigid registration. The difference between CTgRT and MRgRT alignment was calculated to quantify the inter-fractional image-guidance uncertainty and estimate PTV margins. Dose from the clinical beam sets was recalculated on the synthetic-CTs for comparative analysis.

resultsThe CTgRT alignment compared to MRgRT were -0.59 ± 3.49 mm, 2.04 ± 3.96 mm, and 1.23 ± 1.20 mm in left-right (LR), superior-inferior (SI), and anterior-posterior (AP) directions, respectively. Compared to clinical plans, the dosimetric parameters of recalculated synthetic-CT plans, V95 and D95, were significantly lower, while the homogeneity index was significantly higher (p < 0.001 for each metric). Compared to MRgRT, CTgRT required additional treatment margins of 10.0 mm in LR, 11.5 mm in SI, and 4.6 mm in AP directions.

conclusionsWe quantified the dosimetric difference in treating intramuscular metastases using MRgRT versus CTgRT and showed that treatment margin can be reduced by at least 5 mm in each direction with MRgRT.

Indexed as

Magnetic Resonance ImagingMuscle NeoplasmsRadiotherapy, Image-GuidedRadiotherapy Planning, Computer-AssistedRadiotherapy Setup ErrorsTomography, X-Ray ComputedFemaleHumansImage Processing, Computer-AssistedMaleOrgans at RiskPrognosisRadiotherapy DosageRadiotherapy, Intensity-ModulatedUncertaintyimage‐guidanceMR‐Linacoligometastasisradiotherapytreatment margins

Identifiers

PMID42003063
PMCPMC13092809

What OpenQuestion holds

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LicenceCC BY
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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.