An artificial intelligence (AI) that reconstructs MRI images of moving tumours can do so in seconds, offering a significant improvement on current methods to optimise radiotherapy treatment in the clinic.
The AI, called Dracula (short for ‘deep radial convolutional neural network’) can replicate four-dimensional MRI images of a patient’s whole anatomy, including tumours and healthy organs, from low quality images containing artefacts – visual anomalies not present in reality that arise from scans with incomplete information.
It can take up to several hours to reconstruct high quality 4D MRI images from these under-sampled scans, whereas the AI takes an average of 28 seconds.
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These reconstructed images could accurately guide the delivery of radiotherapy to tumours by tracking their movement while a patient is breathing. The process is called magnetic resonance guided radiotherapy (MRgRT) and allows radiotherapy treatment to be adapted accordingly to improve patient outcomes.
The research was published in the journal Radiotherapy and Oncology, and was led by scientists at The Institute of Cancer Research, London and The Royal Marsden NHS Foundation Trust. It was funded by Cancer Research UK, NVIDIA and the NIHR Biomedical Research Centre at The Royal Marsden and the ICR.
Faster image acquisition
To treat patients with tumours that move as they breathe, 4D MRI images are needed to show the 3D volume of the tumour and surrounding organs at different time points during breathing – known as a respiratory phase.
By combining numerous respiratory phases, the midposition image can then be calculated from the 4D MRI image. Midposition images reveal the average position of the tumour and its movement from breathing, and are needed to accurately plan radiotherapy treatment.
An alternative to treating these types of tumours is to have a patient hold their breath so the tumour no longer moves, but this can be strenuous for the patient and makes treatment longer and more difficult.
Dracula allows 4D MRI and midposition images to be obtained in seconds – and potentially online just before treatment – to guide the delivery of radiotherapy in real-time, as well as make treatment more adaptable based on the patient’s anatomy.
In the clinic, the images reconstructed by Dracula could be used to guide the ICR and The Royal Marsden’s MR Linac machine – a novel combination technology that uses an MRI scanner and linear accelerator to locate and deliver radiotherapy doses to tumours. This means high hits of radiation could be precisely targeted to just the tumour, minimising the risk of affecting healthy organs.