Generation of abdominal synthetic CTs from 0.35T MR images using generative adversarial networks for MR-only liver radiotherapy

TL;DR

This study evaluates deep learning models, cGAN and cycleGAN, for generating accurate synthetic CT images from low-field MRI for MR-only liver radiotherapy, demonstrating promising dose calculation accuracy.

Contribution

It compares the performance of cGAN and cycleGAN in generating synthetic CTs from 0.35T MRI for liver radiotherapy, highlighting their accuracy and potential clinical utility.

Findings

Both models achieved over 95% gamma pass rate at 2%, 2mm criteria.

sCTcGAN had smaller MAE and better dose accuracy than sCTcycleGAN.

Generated sCT images enabled accurate dose calculations within 1% for liver radiotherapy.

Abstract

Electron density maps must be accurately estimated to achieve valid dose calculation in MR-only radiotherapy. The goal of this study is to assess whether two deep learning models, the conditional generative adversarial network (cGAN) and the cycle-consistent generative adversarial network (cycleGAN), can generate accurate abdominal synthetic CT (sCT) images from 0.35T MR images for MR-only liver radiotherapy. A retrospective study was performed using CT images and 0.35T MR images of 12 patients with liver (n=8) and non-liver abdominal (n=4) cancer. CT images were deformably registered to the corresponding MR images to generate deformed CT (dCT) images for treatment planning. Both cGAN and cycleGAN were trained using MR and dCT transverse slices. Four-fold cross-validation testing was conducted to generate sCT images for all patients. The HU prediction accuracy was evaluated by voxel-wise similarity metric between each dCT and sCT image for all 12 patients. dCT-based and sCT-based dose distributions were compared using gamma and dose-volume histogram (DVH) metric analysis for 8 liver patients. sCTcycleGAN achieved the average mean absolute error (MAE) of 94.1 HU, while sCTcGAN achieved 89.8 HU. In both models, the average gamma passing rates within all volumes of interest were higher than 95% using a 2%, 2 mm criterion, and 99% using a 3%, 3 mm criterion. The average differences in the mean dose and DVH metrics were within +/-0.6% for the planning target volume and within +/-0.15% for evaluated organs in both models. Results demonstrated that abdominal sCT images generated by both cGAN and cycleGAN achieved accurate dose calculation for 8 liver radiotherapy plans. sCTcGAN images had smaller average MAE and achieved better dose calculation accuracy than sCTcyleGAN images. More abdominal patients will be enrolled in the future to further evaluate two models.