title: Assessing the image quality of pelvic MR images acquired with a flat couch for radiotherapy treatment planning.
abstract: OBJECTIVE
  To improve the integration of MRI with radiotherapy treatment planning, our department fabricated a flat couch top for our MR scanner. Setting up using this couch top meant that the patients were physically higher up in the scanner and, posteriorly, a gap was introduced between the patient and radiofrequency coil.
  
  
  METHODS
  Phantom measurements were performed to assess the quantitative impact on image quality. A phantom was set up with and without the flat couch insert in place, and measurements of image uniformity and signal to noise were made. To assess clinical impact, six patients with pelvic cancer were recruited and scanned on both couch types. The image quality of pairs of scans was assessed by two consultant radiologists.
  
  
  RESULTS
  The use of the flat couch insert led to a drop in image signal to noise of approximately 14%. Uniformity in the anteroposterior direction was affected the most, with little change in right-to-left and feet-to-head directions. All six patients were successfully scanned on the flat couch, although one patient had to be positioned with their arms by their sides. The image quality scores showed no statistically significant change between scans with and without the flat couch in place.
  
  
  CONCLUSIONS
  Although the quantitative performance of the coil is affected by the integration of a flat couch top, there is no discernible deterioration of diagnostic image quality, as assessed by two consultant radiologists. Although the flat couch insert moved patients higher in the bore of the scanner, all patients in the study were successfully scanned.
authors.affiliation: Radiotherapy Physics Department, Northern Ireland Cancer Centre, Belfast, Northern Ireland, UK. mark.mcjury@ggc.scot.nhs.uk
authors.forename: M
authors.initials: M
authors.lastname: McJury
authors.forename: A
authors.initials: A
authors.lastname: O'Neill
authors.forename: M
authors.initials: M
authors.lastname: Lawson
authors.forename: C
authors.initials: C
authors.lastname: McGrath
authors.forename: A
authors.initials: A
authors.lastname: Grey
authors.forename: W
authors.initials: W
authors.lastname: Page
authors.forename: J M
authors.initials: JM
authors.lastname: O'Sullivan
mesh_terms: D006801:Humans; D008279:Magnetic Resonance Imaging / Q000592:standards*; D008297:Male; D008875:Middle Aged; D056888:Patient Positioning / Q000379:methods*; D010388:Pelvis; D019047:Phantoms, Imaging; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000532:radiotherapy; D011856:Radiographic Image Enhancement; D011880:Radiotherapy Planning, Computer-Assisted / Q000295:instrumentation* / Q000379:methods; D015203:Reproducibility of Results