Safety and Feasibility of Magnetic Resonance Imaging Simulation for Radiation Treatment Planning in Pediatric Patients: A Single Institution Experience

Purpose: This study aimed to report on the safety, feasibility, and workflow of using magnetic resonance imaging (MRI) simulation, while immobilized in the treatment position, for radiation therapy treatment planning in the pediatric population. Methods and Materials: Between May and December 2017, 10 pediatric patients completed both MRI and computed tomography imaging simulation in treatment immobilization for radiation therapy planning for central nervous system disease. We report our initial institutional experience and workflow of the use of MRI simulation in immobilization for treatment planning in this population. Results: Ten pediatric patients successfully underwent MRI and computed tomography imaging simulation for CNS disease. Two patients required anesthesia for sedation during the simulations. From our initial experience, MRI simulation was tolerated by all 10 pediatric patients without any safety or clinical issues, including those who required anesthesia. Conclusions: Our initial experience supports the use of MRI simulation for radiation treatment planning in the pediatric population, with and without anesthetic sedation, as a safe and feasible image-guidance tool. This is particularly useful in the treatment of pediatric patients because MRI simulation enables superior, soft-tissue, anatomic imaging for a more robust delineation of organs at risk and target volumes without increasing radiation exposure.