To facilitate radiotherapy, patient 3D imaging called simulation is essential prior to sophisticated computer treatment planning. Over decades, we have been using Computed Tomography (CT) as the primary simulator CT-Sim, with Magnetic Resonance Imaging (MRI) being overlaid to the CT image set for the target and organs localization. CT images are important for RT plan radiation dose calculation while the MRI ones are excellent for the body tissues discrimination. Simulation images are also used as a 3D reference frame to set up the patient precisely for the subsequent actual RT treatment. With the advancement of technology, MR images at certain body sites can be converted to pseudo-CT good enough for RT planning. Hence the dedicated MRI can become the MR-Sim, sharing the workload of the CT-Sim, improving the image quality, and achieving better treatment simulation. It is highly desirable if the Oncology Department could install an MR-Sim on site in parallel with the existing CT-Sim, so that all the simulation processes could be completed in one go in the same department.
In New Territories West Cluster Tuen Mun Hospital an Oncology-based MR-Sim was installed in 2022. This is the first such equipment in HA costing about HK$23Million. With the implementation of this MR-Sim, the equipment is taking up most of the RT simulation works requiring MR imaging, alleviating the burden of the Radiology-based MRI units, and greatly improving the workflow of our oncology patients during the simulation processes. Upon initial utilization, the new MR-Sim is now operating with a throughput of about eight oncology patients per day-session of simulation. The Oncology Department finds it very valuable, useful and convenient in serving our patients, leading to even higher quality treatments.
In this presentation, the improvement of patient services and developments in the relevant aspects in TMH will be shared. These include Image-Guided Brachytherapy, escalation of simulation quality, MR-Only treatment planning, and functional MRI research. These contribute to the differences that the new MR-Simulator has brought to the Oncology Department of the Tuen Mun Hospital since 2022.
