- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT06106997
Clinical Feasibility of Brain Radiotherapy Using Synthetic CTs in an MRI-only Workflow
Feasibility Study of an MRI-only Workflow: Use of Synthetic CTs Generated From MRI Data for MRI-based Radiotherapy
The goal of this observational study is to show the feasibility of an MRI-only workflow in brain radiotherapy. The main question it aims to answer is:
- Is an MRI-only workflow based on deep learning sCTs feasible in clinical routine? Participants will be treated as in clinical routine, but treatment planning will be based on sCTs, that are generated from MRI images. The dosimetrical equivalence to the standard CT based workflow will be tested at several points in the study.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
The purpose of this clinical study is to investigate the clinical feasibility of a deep learning-based MRI-only workflow for brain radiotherapy, that eliminates the registration uncertainty through calculation of a synthetic CT (sCT) from MRI data.
A total of 54 patients with an indication for radiation treatment of the brain and stereotactic mask immobilization will be recruited. All study patients will receive standard therapy and imaging including both CT and MRI. All patients will receive dedicated RT-MRI scans in treatment position. An sCT will be reconstructed from an acquired MRI DIXON-sequence using a commercially available deep learning solution on which subsequent radiotherapy planning will be performed. Through multiple quality assurance (QA) measures and reviews during the course of the study, the feasibility of an MRI-only workflow and comparative parameters between sCT and standard CT workflow will be investigated holistically. These QA measures include feasibility and quality of image guidance (IGRT) at the linear accelerator using sCT derived digitally reconstructed radiographs in addition to potential dosimetric deviations between the CT and sCT plan. The aim of this clinical study is to establish a brain MRI-only workflow as well as to identify risks and QA mechanisms to ensure a safe integration of deep learning-based sCT into radiotherapy planning and delivery.
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Florian Putz, PD Dr. med.
- Phone Number: ++49(0)9131-85-33405
- Email: florian.putz@uk-erlangen.de
Study Contact Backup
- Name: Christoph Bert, Prof. Dr. rer. nat
- Phone Number: ++49(0)9131-85-44213
- Email: christoph.bert@uk-erlangen.de
Study Locations
-
-
-
Erlangen, Germany, 91054
- Erlangen, Universitätsklinikum Strahlenklinik
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Written informed consent
- Patient older than 18 years
- Tumor or metastases in the brain
- Immobilization with stereotactic mask
- Treatment on stereotactic linear accelerator (2.5 mm leafs) equipped with 2D/2D X-ray system
Exclusion Criteria:
- Metal in the body, metal implants, pacemakers or other patient-specific factors that are a contraindication to an MRI scan
- Metal implants, pacemakers or other patient-specific factors associated with increased risk from an MRI scan
- Renal insufficiency (eGFR < 60 ml/min), allergy or other patient-specific factors that constitute a contraindication to contrast administration
- Renal insufficiency (eGFR < 60 ml/min), allergy or other patient-specific factors associated with an increased risk from contrast administration
- Patients who are institutionalized in care facilities, prisons or other supervised facilities.
- Patients under guardianship
- Non-consenting patients
- Pregnant or breastfeeding patients
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Other
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Other: sCT workflow
|
brain radiotherapy planned on synthetic CTs
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Proportion of patients that can successfully be treated in an MRI-only workflow
Time Frame: 12 month
|
All criteria have to be met for the MRI-only workflow to be classified as successful: Verification criteria that will be assessed:
|
12 month
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Reasons that lead to unfeasibility of an MRI-only workflow
Time Frame: 12 month
|
Presence (Yes/No) of individual reasons responsible for the unfeasibility of the MRI-only workflow, as assessed with a predefined checklist.
|
12 month
|
Dosimetric differences between MRI-only and standard workflow for radiotherapy treatment planning
Time Frame: 12 month
|
Paired difference in Dose-volume-histogram parameters (Target coverage, mean, median, near maximum and minimum dose) between MRI-only and standard radiotherapy treatment workflow.
|
12 month
|
Measurement of intra-MRI patient positional changes
Time Frame: 12 month
|
Patient shift (vector magnitude) and rotational errors occuring during the course of MRI acquisition due to patient movement, as assessed by rigid registration of the last acquired MRI sequence in reference to the first sequence.
|
12 month
|
Organ at risk contouring accuracy on MRI data
Time Frame: 12 month
|
Similarity of organ at risk segmentations defined in MRI compared to reference segmentations defined in CT as assessed by the volumetric and surface Dice score, as well as mean surface and Hausdorff distances.
|
12 month
|
Collaborators and Investigators
Investigators
- Principal Investigator: Christoph Bert, Prof. Dr. rer. nat, Universitätsklinikum Erlangen, Strahlenklinik
- Principal Investigator: Florian Putz, PD Dr. med., Universitätsklinikum Erlangen, Strahlenklinik
Study record dates
Study Major Dates
Study Start (Estimated)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- sCT-Feasibility
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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