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Boroun A, Gholamhosseinian H, Montazerabadi A, Molana SH, Pashaei F. Optimizing the Radiation Treatment Planning of Brain Tumors by Integration of Functional MRI and White Matter Tractography. J Biomed Phys Eng 2023; 13:239-250. [PMID: 37312891 PMCID: PMC10258212 DOI: 10.31661/jbpe.v0i0.2210-1547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 12/20/2022] [Indexed: 06/15/2023]
Abstract
Background Diffusion tensor imaging (DTI) and functional magnetic resonance imaging (fMRI) present the ability to selectively protect functional regions and fiber tracts of the brain when brain tumors are treated with radiotherapy. Objective This study aimed to assess whether the incorporation of fMRI and DTI data into the radiation treatment planning process of brain tumors could prevent the neurological parts of the brain from high doses of radiation. Material and Methods In this investigational theoretical study, the fMRI and DTI data were obtained from eight glioma patients. This patient-specific fMRI and DTI data were attained based on tumor location, the patient's general conditions, and the importance of the functional and fiber tract areas. The functional regions, fiber tracts, anatomical organs at risk, and the tumor were contoured for radiation treatment planning. Finally, the radiation treatment planning with and without fMRI & DTI information was obtained and compared. Results The mean dose to the functional areas and the maximum doses were reduced by 25.36% and 18.57% on fMRI & DTI plans compared with the anatomical plans. In addition, 15.59% and 20.84% reductions were achieved in the mean and maximum doses of the fiber tracts, respectively. Conclusion This study demonstrated the feasibility of using fMRI and DTI data in radiation treatment planning to maximize radiation protection of the functional cortex and fiber tracts. The mean and maximum doses significantly decreased to neurologically relevant brain regions, resulting in reducing the neuro-cognitive complications and improving the patient's quality of life.
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Affiliation(s)
- Arman Boroun
- Radiation Sciences Research Center (RSRC), Aja University of Medical Sciences, Tehran, Iran
| | | | - Alireza Montazerabadi
- Medical Physics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Hadi Molana
- Department of Radiation Oncology, Aja University of Medical Sciences, Tehran, Iran
| | - Fakhereh Pashaei
- Radiation Sciences Research Center (RSRC), Aja University of Medical Sciences, Tehran, Iran
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Abstract
Amongst the several types of brain cancers known to humankind, glioma is one of the most severe and life-threatening types of cancer, comprising 40% of all primary brain tumors. Recent reports have shown the incident rate of gliomas to be 6 per 100,000 individuals per year globally. Despite the various therapeutics used in the treatment of glioma, patient survival rate remains at a median of 15 months after undergoing first-line treatment including surgery, radiation, and chemotherapy with Temozolomide. As such, the discovery of newer and more effective therapeutic agents is imperative for patient survival rate. The advent of computer-aided drug design in the development of drug discovery has emerged as a powerful means to ascertain potential hit compounds with distinctively high therapeutic effectiveness against glioma. This review encompasses the recent advances of bio-computational in-silico modeling that have elicited the discovery of small molecule inhibitors and/or drugs against various therapeutic targets in glioma. The relevant information provided in this report will assist researchers, especially in the drug design domains, to develop more effective therapeutics against this global disease.
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Ding H, Huang Y, Li Z, Li S, Chen Q, Xie C, Zhong Y. Prediction of IDH Status Through MRI Features and Enlightened Reflection on the Delineation of Target Volume in Low-Grade Gliomas. Technol Cancer Res Treat 2020; 18:1533033819877167. [PMID: 31564237 PMCID: PMC6767744 DOI: 10.1177/1533033819877167] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Isocitrate dehydrogenase mutational status defines distinct biologic behavior and
clinical outcomes in low-grade gliomas. We sought to determine magnetic resonance imaging
characteristics associated with isocitrate dehydrogenase mutational status to evaluate the
predictive roles of magnetic resonance imaging features in isocitrate dehydrogenase
mutational status and therefore their potential impact on the determination of clinical
target volume in radiotherapy. Forty-eight isocitrate dehydrogenase-mutant and 28
isocitrate dehydrogenase–wild-type low-grade gliomas were studied. Isocitrate
dehydrogenase mutation was related to more frequency of cortical involvement compared to
isocitrate dehydrogenase–wild-type group (34/46 vs 6/24, P = .0001).
Peritumoral edema was less frequent in isocitrate dehydrogenase–mutant tumors (32.6% vs
58.3% for isocitrate dehydrogenase–wild-type tumors, P = .0381).
Isocitrate dehydrogenase–wild-type tumors were more likely to have a nondefinable border,
while isocitrate dehydrogenase–mutant tumors had well-defined borders (66.7% vs 39.1%,
P = .0287). Only 8 (17.4%) of 46 of the isocitrate dehydrogenase–mutant
tumors demonstrated marked enhancement, while this was 66.7% in isocitrate–wild-type
tumors (P < .0001). Choline–creatinine ratio for isocitrate
dehydrogenase–wild-type tumors was significantly higher than that for isocitrate
dehydrogenase–mutant tumors. In conclusion, frontal location, well-defined border,
cortical involvement, less peritumoral edema, lack of enhancement, and low
choline–creatinine ratio were predictive for the definition of isocitrate
dehydrogenase–mutant low-grade gliomas. Magnetic resonance imaging can provide an
advantage in the detection of isocitrate dehydrogenase status indirectly and indicate the
need to explore new design for treatment planning in gliomas. Choline–creatinine ratio in
magnetic resonance spectroscopy could be a potential more reasonable reference for the new
design of delineation of target volume in low-grade gliomas.
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Affiliation(s)
- Haixia Ding
- Department of Chemotherapy and Radiation Therapy, Zhongnan Hospital, Wuhan University, Wuchang District, Wuhan, China.,Hubei Key Laboratory of Tumor Biological Behaviors, Wuchang District, Wuhan, China.,Hubei Cancer Clinical Study Center, Wuhan, China
| | - Yong Huang
- Department of Chemotherapy and Radiation Therapy, Zhongnan Hospital, Wuhan University, Wuchang District, Wuhan, China.,Hubei Key Laboratory of Tumor Biological Behaviors, Wuchang District, Wuhan, China.,Hubei Cancer Clinical Study Center, Wuhan, China
| | - Zhiqiang Li
- Department of Neurologic Surgery, Zhongnan Hospital, Wuhan University, Wuchang District, Wuhan, China
| | - Sirui Li
- Department of Radiology, Zhongnan Hospital, Wuhan University, Wuchang District, Wuhan, China
| | - Qiongrong Chen
- Department of Pathology, Zhongnan Hospital, Wuhan University, Wuchang District, Wuhan, China
| | - Conghua Xie
- Department of Chemotherapy and Radiation Therapy, Zhongnan Hospital, Wuhan University, Wuchang District, Wuhan, China.,Hubei Key Laboratory of Tumor Biological Behaviors, Wuchang District, Wuhan, China.,Hubei Cancer Clinical Study Center, Wuhan, China
| | - Yahua Zhong
- Department of Chemotherapy and Radiation Therapy, Zhongnan Hospital, Wuhan University, Wuchang District, Wuhan, China.,Hubei Key Laboratory of Tumor Biological Behaviors, Wuchang District, Wuhan, China.,Hubei Cancer Clinical Study Center, Wuhan, China
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Wang M, Ma H, Wang X, Guo Y, Xia X, Xia H, Guo Y, Huang X, He H, Jia X, Xie Y. Integration of BOLD-fMRI and DTI into radiation treatment planning for high-grade gliomas located near the primary motor cortexes and corticospinal tracts. Radiat Oncol 2015; 10:64. [PMID: 25884395 PMCID: PMC4357178 DOI: 10.1186/s13014-015-0364-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 02/19/2015] [Indexed: 01/03/2023] Open
Abstract
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.
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Affiliation(s)
- Minglei Wang
- Department of Radiology, General Hospital of Ningxia Medical University, Yinchuan, China.
| | - Hui Ma
- Ningxia Key Laboratory for Cerebrocranial Diseases, Yinchuan, China. .,Department of Neurosurgery, General Hospital of Ningxia Medical University, Yinchuan, China.
| | - Xiaodong Wang
- Department of Radiology, General Hospital of Ningxia Medical University, Yinchuan, China. .,Ningxia Key Laboratory for Cerebrocranial Diseases, Yinchuan, China.
| | - Yanhong Guo
- Department of Radiation Oncology, General Hospital of Ningxia Medical University, Yinchuan, China.
| | - Xinshe Xia
- Department of Radiation Oncology, General Hospital of Ningxia Medical University, Yinchuan, China.
| | - Hechun Xia
- Ningxia Key Laboratory for Cerebrocranial Diseases, Yinchuan, China. .,Department of Neurosurgery, General Hospital of Ningxia Medical University, Yinchuan, China.
| | - Yulin Guo
- Department of Radiology, General Hospital of Ningxia Medical University, Yinchuan, China.
| | - Xueying Huang
- Department of Radiology, General Hospital of Ningxia Medical University, Yinchuan, China.
| | - Hong He
- Department of Radiology, Xi'an NO.1 Hospital, Xi'an, China.
| | - Xiaoxiong Jia
- Department of Neurosurgery, General Hospital of Ningxia Medical University, Yinchuan, China.
| | - Yan Xie
- Tissue Organ Bank & Tissue Engineering Centre, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China. .,Tissue Repair and Regeneration Program, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD, Australia.
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