{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T03:57:35Z","timestamp":1792555055790,"version":"4.5.0"},"reference-count":46,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,2,17]],"date-time":"2022-02-17T00:00:00Z","timestamp":1645056000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Physics"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>In this study, we investigate the use of magnetic resonance imaging (MRI) for the clinical evaluation of gating treatment robustness in carbon\u2010ion radiotherapy (CIRT) of pancreatic cancer. Indeed, MRI allows radiation\u2010free repeated scans and fast dynamic sequences for time\u2010resolved (TR) imaging (cine\u2010MRI), providing information on inter\u2010 and intra\u2010fraction cycle\u2010to\u2010cycle variations of respiratory motion. MRI can therefore support treatment planning and verification, overcoming the limitations of the current clinical standard, that is, four\u2010dimensional computed tomography (4DCT), which describes an \u201caverage\u201d breathing cycle neglecting breathing motion variability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We integrated a technique to generate a virtual CT (vCT) from 3D MRI with a method for 3D reconstruction from 2D cine\u2010MRI, to produce TR vCTs for dose recalculations. For eight patients, the method allowed evaluating inter\u2010fraction variations at end\u2010exhale and intra\u2010fraction cycle\u2010to\u2010cycle variability within the gating window in terms of tumor displacement and dose to the target and organs at risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The median inter\u2010fraction tumor motion was in the range 3.33\u201312.16\u00a0mm, but the target coverage was robust (\u20100.4% median\n                      <jats:italic>D<\/jats:italic>\n                      <jats:sub>95%<\/jats:sub>\n                      variation). Concerning cycle\u2010to\u2010cycle variations, the gating technique was effective in limiting tumor displacement (1.35\u00a0mm median gating motion) and corresponding dose variations (\u20103.9% median\n                      <jats:italic>D<\/jats:italic>\n                      <jats:sub>95%<\/jats:sub>\n                      variation). The larger exposure of organs at risk (duodenum and stomach) was caused by inter\u2010fraction motion, whereas intra\u2010fraction cycle\u2010to\u2010cycle dose variations were limited.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study proposed a method for the generation of TR vCTs from MRI, which enabled an off\u2010line evaluation of gating treatment robustness and suggested its feasibility to support treatment planning of pancreatic tumors in CIRT.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mp.15510","type":"journal-article","created":{"date-parts":[[2022,2,6]],"date-time":"2022-02-06T00:48:02Z","timestamp":1644108482000},"page":"2386-2395","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Time\u2010resolved MRI for off\u2010line treatment robustness evaluation in carbon\u2010ion radiotherapy of pancreatic cancer"],"prefix":"10.1002","volume":"49","author":[{"given":"Giorgia","family":"Meschini","sequence":"first","affiliation":[{"name":"Department of Electronics, Information and Bioengineering Politecnico di Milano  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Vai","sequence":"additional","affiliation":[{"name":"Medical Physics Unit National Center for Oncological Hadrontherapy (Fondazione CNAO)  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amelia","family":"Barcellini","sequence":"additional","affiliation":[{"name":"Clinical Department National Center for Oncological Hadrontherapy (Fondazione CNAO)  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Fontana","sequence":"additional","affiliation":[{"name":"Clinical Bioengineering Unit National Center for Oncological Hadrontherapy (Fondazione CNAO)  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