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4D MRI for Treatment Planning 
of Liver TumorsJessica Scholey1; Horatio Thomas1; Xin Miao2; 
Dianne Ferguson3; Mary Feng1

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Left: Example axial slice of a radiation treatment plan optimized using CT-derived target. Right: Boxplot distribution for all 17 PTVs covered by 90% of the prescription dose.

Stereotactic body radiation therapy (SBRT) is increasingly being used to manage primary and metastatic liver tumors4,5,6. Accurately accounting for respiratory motion is imperative when targeting liver tumors with radiation.

This study demonstrates the feasibility of using hepatobiliary contrast-enhanced 4D MRI to delineate gross liver tumors directly throughout the respiratory cycle. The lower coverage of directly visualized MRI targets in plans generated using standard of care 4D CT-derived targets suggests that the adoption of 4D MRI for motion management may improve radiation treatment of liver lesions and reduce the risk of marginal misses.

4D MRI – RT Respiratory Self-Gating

Patient motion management for MR imaging

MRI for Radiation Therapy

The key to personalized RT

1
Department of Radiation Oncology, University of California, San Francisco, CA, USA
2
Siemens Medical Solutions USA Inc., Boston, MA, USA
3
Department of Radiation Oncology, Brigham and Women’s Hospital, Dana Farber Cancer Institute and Harvard  Medical School, Boston, MA, USA
4
Mahadevan A, Blanck O, Lanciano R, et al. Stereotactic Body Radiotherapy (SBRT) for liver metastasis – clinical outcomes from the international multi-institutional RSSearch® Patient Registry. Radiation Oncology. 2018;13(1):1-11.   
5
Ohri N, Tomé WA, Romero AM, et al. Local control after stereotactic body radiation therapy for liver tumors. International Journal of Radiation Oncology* Biology* Physics. 2021;110(1):188-195.   
6
Doi H, Beppu N, Kitajima K, Kuribayashi K. Stereotactic body radiation therapy for liver tumors: current status and perspectives. Anticancer Research. 2018;38(2):591-599. 
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