Integration of Diffusion Magnetic Resonance Tractography into tomotherapy radiation treatment planning for high-grade gliomas
| Autor: | Riccardo Calandrino, Luisa Altabella, Antonella del Vecchio, Sara Broggi, Paola Mangili, Valentina Pieri, Nadia Di Muzio, Antonella Castellano, Gian Marco Conte, Antonella Iadanza, Andrea Falini, Nicoletta Anzalone |
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| Přispěvatelé: | Altabella, Luisa, Broggi, Sara, Mangili, Paola, Conte, Gian Marco, Pieri, Valentina, Iadanza, Antonella, del Vecchio, Antonella, Anzalone, Nicoletta, di Muzio, Nadia, Calandrino, Riccardo, Falini, Andrea, Castellano, Antonella |
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Radiology Nuclear Medicine and Imaging medicine.medical_treatment Biophysics Planning target volume General Physics and Astronomy Tomotherapy White matter Brain Neoplasm 03 medical and health sciences Physics and Astronomy (all) 0302 clinical medicine medicine Humans Radiology Nuclear Medicine and imaging Radiation treatment planning Aged medicine.diagnostic_test Radiotherapy business.industry Brain Neoplasms Radiotherapy Planning Computer-Assisted Magnetic resonance imaging Radiotherapy Dosage General Medicine Glioma Middle Aged Radiation therapy Brain tumor medicine.anatomical_structure Diffusion Tensor Imaging Biophysic 030220 oncology & carcinogenesis Female Diffusion MR Tractography Radiotherapy Intensity-Modulated Neoplasm Grading Nuclear medicine business 030217 neurology & neurosurgery Tractography Diffusion MRI Human |
| Popis: | Introduction Fractionated radiotherapy in brain tumors is commonly associated with several detrimental effects, largely related to the higher radiosensitivity of the white matter (WM) with respect to gray matter. However, no dose constraints are applied to preserve WM structures at present. Magnetic Resonance (MR) Tractography is the only technique that allows to visualize in vivo the course of WM eloquent tracts in the brain. In this study, the feasibility of integrating MR Tractography in tomotherapy treatment planning has been investigated, with the aim to spare eloquent WM regions from the dose delivered during treatment. Methods Nineteen high grade glioma patients treated with fractionated radiotherapy were enrolled. All the patients underwent pre-treatment MR imaging protocol including Diffusion Tensor Imaging (DTI) acquisitions for MR Tractography analysis. Bilateral tracts involved in several motor, language, cognitive functions were reconstructed and these fiber bundles were integrated into the Tomotherapy Treatment planning system. The original plans without tracts were compared with the optimized plans incorporating the fibers, to evaluate doses to WM structures in the two differently optimized plans. Results No significant differences were found between plans in terms of planning target volume (PTV) coverage between the original plans and the optimized plans incorporating fiber tracts. Comparing the mean as well as the maximal dose (Dmean and Dmax), a significant dose reduction was found for most of the tracts. The dose sparing was more relevant for contralateral tracts (P Conclusion The integration of MR Tractography into radiotherapy planning is feasible and beneficial to preserve important WM structures without reducing the clinical goal of radiation treatment. |
| Databáze: | OpenAIRE |
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