Integration of BOLD-fMRI and DTI into radiation treatment planning for high-grade gliomas located near the primary motor cortexes and corticospinal tracts

Radiation Oncology

Yan Xie⁴  Xiaoxiong Jia²  Hong He³  Xueying Huang⁵  Yulin Guo⁵  Hechun Xia²  Xinshe Xia¹  Yanhong Guo¹  Xiaodong Wang⁶  Hui Ma²  Minglei Wang⁵ 

[1] Department of Radiation Oncology, General Hospital of Ningxia Medical University, Yinchuan, China;Department of Neurosurgery, General Hospital of Ningxia Medical University, Yinchuan, China;Department of Radiology, Xi’an NO.1 Hospital, Xi’an, China;Tissue Repair and Regeneration Program, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD, Australia;Department of Radiology, General Hospital of Ningxia Medical University, Yinchuan, China;Ningxia Key Laboratory for Cerebrocranial Diseases, Yinchuan, China

关键词: Radiation treatment planning;    Intensity-modulated radiation therapy (IMRT);    Three-dimensional conformal radiation treatment (3DCRT);    Diffusion tensor imaging (DTI);    Blood oxygen level dependent functional magnetic resonance imaging (BOLD-fMRI);    High-grade gliomas;   

Others  :  1139644
DOI  :  10.1186/s13014-015-0364-1

 received in 2014-10-28, accepted in 2015-02-19,  发布年份 2015

【 摘 要 】

Background

The main objective of this study was to evaluate the efficacy of integrating the blood oxygen level dependent functional magnetic resonance imaging (BOLD-fMRI) and diffusion tensor imaging (DTI) data into radiation treatment planning for high-grade gliomas located near the primary motor cortexes (PMCs) and corticospinal tracts (CSTs).

Methods

A total of 20 patients with high-grade gliomas adjacent to PMCs and CSTs between 2012 and 2014 were recruited. The bilateral PMCs and CSTs were located in the normal regions without any overlapping with target volume of the lesions. BOLD-fMRI, DTI and conventional MRI were performed on patients (Karnofsky performance score ≥ 70) before radical radiotherapy treatment. Four different imaging studies were conducted in each patient: a planning computed tomography (CT), an anatomical MRI, a DTI and a BOLD-fMRI. For each case, three treatment plans (3DCRT, IMRT and IMRT_PMC&CST) were developed by 3 different physicists using the Pinnacle planning system.

Results

Our study has shown that there was no significant difference between the 3DCRT and IMRT plans in terms of dose homogeneity, but IMRT displayed better planning target volume (PTV) dose conformity. In addition, we have found that the Dmax and Dmean to the ipsilateral and contralateral PMC and CST regions were considerably decreased in IMRT_PMC&CST group (p < 0.001).

Conclusions

In conclusion, integration of BOLD-fMRI and DTI into radiation treatment planning is feasible and beneficial. With the assistance of the above-described techniques, the bilateral PMCs and CSTs adjacent to the target volume could be clearly marked as OARs and spared during treatment.

【 授权许可】

   
2015 Wang et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

Figure 2.

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