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Are cone beam CT image matching skills transferrable from planning CT to planning MRI for MR-only prostate radiotherapy?

Lookup NU author(s): Dr Hazel McCallum, Dr Rachel Pearson, JJ Wyatt



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


OBJECTIVES: Treatment verification for MR-only planning has focused on fiducial marker matching, however, these are difficult to identify on MR. An alternative is using the MRI for soft-tissue matching with cone beam computed tomography images (MR-CBCT). However, therapeutic radiographers have limited experience of MRI. This study aimed to assess transferability of therapeutic radiographers CT-CBCT prostate image matching skills to MR-CBCT image matching. METHODS: 23 therapeutic radiographers with 3 months-5 years' experience of online daily CT-CBCT soft-tissue matching prostate cancer patients participated. Each observer completed a baseline assessment of 10 CT-CBCT prostate soft-tissue image matches, followed by 10 MR-CBCT prostate soft-tissue image match assessment. A MRI anatomy training intervention was delivered and the 10 MR-CBCT prostate soft-tissue image match assessment was repeated. Limits of agreement were calculated as the disagreement of the observers with mean of all observers. RESULTS: Limits of agreement at CT-CBCT baseline were 2.8 mm, 2.8 mm, 0.7 mm (vertical, longitudinal, lateral). MR-CBCT matches prior to training were 3.3 mm, 3.1 mm, 0.9 mm, and after training 2.6 mm, 2.4 mm, 1.1 mm (vertical, longitudinal, lateral). Results show similar limits of agreement across the assessments, and variation reduced following the training intervention. CONCLUSION: This suggests therapeutic radiographers' prostate CBCT image matching skills are transferrable to a MRI planning scan, since MR-CBCT matching has comparable observer variation to CT-CBCT matching. ADVANCES IN KNOWLEDGE: This is the first publication assessing interobserver MR-CBCT prostate soft tissue matching in an MR-only pathway.

Publication metadata

Author(s): Brooks RL, McCallum HM, Pearson RA, Pilling K, Wyatt J

Publication type: Article

Publication status: Published

Journal: British Journal of Radiology

Year: 2021

Volume: 94

Issue: 1123

Print publication date: 01/07/2021

Online publication date: 29/04/2021

Acceptance date: 31/03/2021

Date deposited: 08/07/2021

ISSN (print): 0007-1285

ISSN (electronic): 1748-880X

Publisher: John Wiley & Sons Ltd.


DOI: 10.1259/bjr.20210146

PubMed id: 33914617


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