case_images: PMC10514477_01
case_images: Comparison of online MR-guided radiotherapy planning and CT simulated localisation.The images are based on the CT simulated positioning, with the target areas of the first MRI positioning projected onto the images in axial (A), coronal (B), sagittal (C) and 3D stereoscopic structures (D) (red line delineates the stomach on the simulation images, the yellow line delineates the stomach on the daily MR images, and the green line delineates the stomach considering 1 cm external expansion from the ICTV). The accumulated DVH curves based on the online MR-guided radiotherapy plan (solid lines) and when this plan is used for CT simulated positioning (dotted lines) (E).
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case_images: f1
case_images: The MR images of stomach tumors were clearer in patients taking scopolamine compared to those not taking it ( Figure S1 ). We found a significant difference between the patient's first MRI-based guided radiotherapy and CT-based simulated localization of the target area outlined ( Figures 1A-D ). Using dose accumulation, there was a large cumulative dose difference between online MRI-guided radiotherapy and CT-simulated localization ( Figure 1E ).
case_images: Tumors of the stomach delineation DSC (numerical value on each panel) of real-time MR imaging and simulation CT imaging (the red line delineates the stomach on the simulation images, the blue line delineates the stomach considering 5 mm external expansion from the ICTV, the yellow line delineates the stomach on the daily MRI images, and the green line delineates the stomach considering 5 mm external expansion from the ICTV).
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case_images: f2
case_images: Tislelizumab and Herceptin during this period. The patient fasted and received anisodamine (10 mg dose) prior to each radiation therapy session ( Figure S2 ). With CBCT guidance, even after enlarging the PTV by 5 mm as usual, the tumor area was not completely covered at any fraction ( Figure 2 ).
case_images: The images from the second treatment fraction with a DSC of 0 for the target area localized by MRI and the target area localized by simulated CT. (The orange line (A, C) delineates the stomach on the CT simulation images, the blue line (B, C) delineates the stomach on the daily MRI images).
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case_images: f3
case_images: Patient with a DSC of 0 at the second treatment, indicating the complete separation from the target area ( Figure 3 ).
case_images: Intra-fractional changes of the anatomical structures by performing MRI before and after treatment at three different fractions. GTV was outlined in red.
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case_images: f4
case_images: Intra-segmental changes during the patient's radiation treatment remained stable on both MRI imaging devices before and after treatment ( Figure 4 ).