Soft Tissue Detection on MRI, Cone Beam CT and Fan Beam CT and Integration of Functional MRI

PRIMARY OBJECTIVES:

I. Establish the technical feasibility of MRI for performing functional soft-tissue targeting
of radiotherapy in the pelvis and thorax. (Group I) II. Acquire clinical MR imaging data to
evaluate image quality tradeoffs and operational parameter settings. (Group I) III. Validate
the selection of MRI technique factors by comparing visibility of soft tissue structures in
MRIs, cone beam (CB)CTs and fan beam (FB)CTs of the same patient. (Group II) IV. Assess the
feasibility of using deformable image registration to map contours from FBCT to MRI, CBCT to
MRI, MRI to MRI and vice versa. (Group II) V. Compare morphologic and functional changes in
target and normal structures, visualized on MRI, CBCT and FBCT images, in response to
radiation therapy and identify opportunities for treatment adaptation. (Group II)

OUTLINE:

Patients undergo MRI and FBCT at baseline, within the first 3 weeks of radiotherapy and
between week 4 and 6 of radiotherapy. Patients with lung cancer may undergo 4 dimensional
(4D) CBCT on the same day as the second and third MRI and FBCT.

Inclusion Criteria:

- Patients with lung cancer visible on CT who are scheduled to receive radiation
treatment to the area of the primary tumor will be eligible for this study - Renal
function tests (blood urea nitrogen [BUN], creatinine [Cr], glomerular filtration rate
[GFR]) within 30 days of MRI with GFR > 59 mL/min

- All patients must give written informed consent on a form that includes Health
Insurance Portability and Accountability Act (HIPAA) authorization; patient therapy
will not be directed by enrollment in this study; participation in this study will not
preclude patient participation in additional therapy protocols; subjects will all be
recruited from patients undergoing radiotherapy at one of the Virginia Commonwealth
University (VCU)-affiliated radiotherapy clinics

Exclusion Criteria:

- Patients requiring continuous supplemental oxygen

- Patients with metal implants including pace makers and defibrillators

- Patients with cerebral aneurysm clips or middle ear implant

- Patients with pain pump, a programmable shunt, or non-surgical metal (i.e. a foreign
body)

- Claustrophobic patients

- Prior radiotherapy to body area under investigation

- No vulnerable populations will be enrolled (prisoners, children, pregnant females, or
institutionalized individuals); women of childbearing potential will undergo a
pregnancy test