Browse by author
Lookup NU author(s): JJ Wyatt, Stephen Hedley, Neil Richmond, Dr Rachel Pearson
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© The Author(s) 2025. Published by Oxford University Press on behalf of the British Institute of Radiology. Objectives: Magnetic Resonance (MR)-only radiotherapy has been clinically implemented but its dose impact has not been assessed in clinical practice. This study evaluated the volume and dose differences between patients treated with CT-only, MR-CT fusion, or MR-only prostate radiotherapy pathways. Methods: Four hundred fifty-four patients from a single centre were treated using MR-only (n=96), CT-only (n=248), or MR-CT (n=110) pathways. Patients were selected for different pathways based solely on geographic location and treatment date. Patients were contoured by the same group of delineators and were planned for 60Gy in 20 fractions by an automated planning algorithm. Clinical Target Volume (CTV), bladder, penile bulb and rectum volumes, and clinical dose constraints were compared with Kurshkal-Wallis tests, adjusted for multiple testing with a P<.05 significance level. Results: Median MR-only CTVs were 5cm3 smaller than CT-only (P=.004). Penile bulb Dmean was 12.0Gy (CT-only), 9.1Gy (MR-CT), and 5.9Gy (MR-only, P<.001), with 79.0%, 90.9%, and 95.8% of patients within constraint. Rectum D2cm3 was 57.4Gy (CT-only), 57.6Gy (MR-CT), and 56.5Gy (MR-only, P<.001), with 35.1%, 20.9%, and 56.2% of patients within rectum V60Gy constraint. Conclusions: The MR-only pathway produced significant reductions of 13% in CTV volume, 51% in penile bulb Dmean, and 2% in rectum D2cm3 compared to CT-only. Advances in knowledge: The dose benefit from MR-only has been assessed in clinical practice, demonstrating significant reductions in penile bulb and rectum doses compared to both CT-only and MR-CT pathways. This suggests the MR-only pathway is required to provide the full benefit of MR contouring to reduce toxicities from prostate radiotherapy.
Author(s): Wyatt JJ, Hedley S, Richmond N, West S, Brooks-Pearson RL, Wintle T, Pearson RA
Publication type: Article
Publication status: Published
Journal: British Journal of Radiology
Year: 2025
Volume: 98
Issue: 1176
Pages: 2099-2105
Print publication date: 01/12/2025
Online publication date: 16/07/2025
Acceptance date: 01/07/2025
Date deposited: 02/02/2026
ISSN (print): 0007-1285
ISSN (electronic): 1748-880X
Publisher: Oxford University Press
URL: https://doi.org/10.1093/bjr/tqaf159
DOI: 10.1093/bjr/tqaf159
Data Access Statement: Research data are stored in an institutional repository and will be shared upon request to the corresponding author.
PubMed id: 40668761
Altmetrics provided by Altmetric
