title: Improved tumour control probability with MRI-based prostate brachytherapy treatment planning.
abstract: BACKGROUND
  Due to improved visibility on MRI, contouring of the prostate is improved compared to CT. The aim of this study was to quantify the benefits of using MRI for treatment planning as compared to CT-based planning for temporary implant prostate brachytherapy.
  
  
  METHODS
  CT and MRI image data of 13 patients were used to delineate the prostate and organs at risk (OARs) and to reconstruct the implanted catheters (typically 12). An experienced treatment planner created plans on the CT-based structure sets (CT-plan) and on the MRI-based structure sets (MRI-plan). Then, active dwell-positions and weights of the CT-plans were transferred to the MRI-based structure sets (CT-plan(MRI-contours)) and resulting dosimetric parameters and tumour control probabilities (TCPs) were studied.
  
  
  RESULTS
  For the CT-plan(MRI-contours) a statistically significant lower target coverage was detected: mean V100 was 95.1% as opposed to 98.3% for the original plans (p < 0.01). Planning on CT caused cold-spots that influence the TCP. MRI-based planning improved the TCPs by 6-10%, depending on the parameters of the radiobiological model used for TCP calculation. Basing the treatment plan on either CT- or MRI-delineations does not influence plan quality.
  
  
  CONCLUSIONS
  Evaluation of CT-based treatment planning by transferring the plan to MRI reveals underdosage of the prostate, especially at the base side. Planning on MRI can prevent cold-spots in the tumour and improves the TCP.
authors.affiliation: Department of Radiation Oncology, Academic Medical Centre, Amsterdam, the Netherlands.
authors.forename: Anna M
authors.initials: AM
authors.lastname: Dinkla
authors.forename: Bradley R
authors.initials: BR
authors.lastname: Pieters
authors.forename: Kees
authors.initials: K
authors.lastname: Koedooder
authors.forename: Niek
authors.initials: N
authors.lastname: van Wieringen
authors.forename: Rob
authors.initials: R
authors.lastname: van der Laarse
authors.forename: Johan N
authors.initials: JN
authors.lastname: van der Grient
authors.forename: Coen R
authors.initials: CR
authors.lastname: Rasch
authors.forename: Caro C
authors.initials: CC
authors.lastname: Koning
authors.forename: Arjan
authors.initials: A
authors.lastname: Bel
mesh_terms: D001918:Brachytherapy / Q000379:methods*; D002277:Carcinoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009929:Organ Size / Q000502:physiology; D058958:Organs at Risk; D011336:Probability; D011467:Prostate / Q000000981:diagnostic imaging* / Q000473:pathology; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed; D047368:Tumor Burden / Q000502:physiology; D014463:Ultrasonography