A systematic review of synthetic CT generation methodologies for use in MRI-only radiotherapy

MRI offers superior soft tissue contrast as compared to CT, which is conventionally used for radiotherapy treatment planning (RTP) and patient positioning verification, resulting in improved target definition. The two modalities are co-registered for RTP, however this introduces a systematic error. Implementing an MRI-only radiotherapy workflow would be advantageous as this error would be eliminated, the patient pathway simplified and patient dose reduced. Unlike CT, in MRI there is no direct relationship between signal intensity and electron density, however various methodologies for MRI-only RTP have been reported.

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