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Karger CP, Elter A, Dorsch S, Mann P, Pappas E, Oldham M. Validation of complex radiotherapy techniques using polymer gel dosimetry. Phys Med Biol 2024; 69:06TR01. [PMID: 38330494 DOI: 10.1088/1361-6560/ad278f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 02/08/2024] [Indexed: 02/10/2024]
Abstract
Modern radiotherapy delivers highly conformal dose distributions to irregularly shaped target volumes while sparing the surrounding normal tissue. Due to the complex planning and delivery techniques, dose verification and validation of the whole treatment workflow by end-to-end tests became much more important and polymer gel dosimeters are one of the few possibilities to capture the delivered dose distribution in 3D. The basic principles and formulations of gel dosimetry and its evaluation methods are described and the available studies validating device-specific geometrical parameters as well as the dose delivery by advanced radiotherapy techniques, such as 3D-CRT/IMRT and stereotactic radiosurgery treatments, the treatment of moving targets, online-adaptive magnetic resonance-guided radiotherapy as well as proton and ion beam treatments, are reviewed. The present status and limitations as well as future challenges of polymer gel dosimetry for the validation of complex radiotherapy techniques are discussed.
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Affiliation(s)
- Christian P Karger
- Department of Medical Physics in Radiation Oncology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, D-69120 Heidelberg, Germany
- National Center for Radiation Research in Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany
| | - Alina Elter
- Department of Medical Physics in Radiation Oncology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, D-69120 Heidelberg, Germany
- National Center for Radiation Research in Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany
- Department of Radiation Oncology, University Hospital Heidelberg, Im Neuenheimer Feld 400, D-69120 Heidelberg, Germany
| | - Stefan Dorsch
- Department of Medical Physics in Radiation Oncology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, D-69120 Heidelberg, Germany
- National Center for Radiation Research in Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany
| | - Philipp Mann
- Department of Medical Physics in Radiation Oncology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, D-69120 Heidelberg, Germany
- National Center for Radiation Research in Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany
| | - Evangelos Pappas
- Radiology & Radiotherapy Sector, Department of Biomedical Sciences, University of West Attica, Athens, Greece
| | - Mark Oldham
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC, United States of America
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Samanci Y, Askeroglu MO, Düzkalir AH, Peker S. Assessing the impact of distortion correction on Gamma Knife radiosurgery for multiple metastasis: Volumetric and dosimetric analysis. BRAIN & SPINE 2024; 4:102791. [PMID: 38584868 PMCID: PMC10995810 DOI: 10.1016/j.bas.2024.102791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 03/11/2024] [Accepted: 03/19/2024] [Indexed: 04/09/2024]
Abstract
Introduction Magnetic resonance imaging (MRI) is a robust neuroimaging technique and is the preferred method for stereotactic radiosurgery (SRS) planning. However, MRI data always contain distortions caused by hardware and patient factors. Research question Can these distortions potentially compromise the effectiveness and safety of SRS treatments? Material and methods Twenty-six MR datasets with multiple metastatic brain tumors (METs) used for Gamma Knife radiosurgery (GKRS) were retrospectively evaluated. A commercially available software was used for distortion correction. Geometrical agreement between corrected and uncorrected tumor volumes was evaluated using MacDonald criteria, Euclidian distance, and Dice similarity coefficient (DSC). SRS plans were generated using uncorrected tumor volumes, which were assessed to determine their coverage of the corrected tumor volumes. Results The median target volume was 0.38 cm3 (range,0.01-12.38 cm3). A maximum displacement of METs of up to 2.87 mm and a median displacement of 0.55 mm (range,0.1-2.87 mm) were noted. The median DSC between uncorrected and corrected MRI was 0.92, and the most concerning case had a DSC of 0.46. Although all plans met the optimization criterion of at least 98% of the uncorrected tumor volume (median 99.55%, range 98.1-100%) receiving at least 100% of the prescription dose, the percent of the corrected tumor volume receiving the total prescription dose was a median of 95.45% (range,23.1-99.5%). Discussion and conclusion MRI distortion, though visually subtle, has significant implications for SRS planning. Regular utilization of corrected MRI is recommended for SRS planning as distortion is sometimes enough to cause a volumetric miss of SRS targets.
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Affiliation(s)
- Yavuz Samanci
- Department of Neurosurgery, Koc University School of Medicine, Istanbul, Turkey
- Gamma Knife Center, Department of Neurosurgery, Koc University Hospital, Istanbul, Turkey
| | - M. Orbay Askeroglu
- Gamma Knife Center, Department of Neurosurgery, Koc University Hospital, Istanbul, Turkey
| | - Ali Haluk Düzkalir
- Gamma Knife Center, Department of Neurosurgery, Koc University Hospital, Istanbul, Turkey
- Department of Neurosurgery, Koc University Hospital, Istanbul, Turkey
| | - Selcuk Peker
- Department of Neurosurgery, Koc University School of Medicine, Istanbul, Turkey
- Gamma Knife Center, Department of Neurosurgery, Koc University Hospital, Istanbul, Turkey
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Chaomulige, Matsuo T, Sugimoto K, Miyaji M, Hosoya O, Ueda M, Kobayashi R, Horii T, Hatada I. Morphometric Analysis of the Eye by Magnetic Resonance Imaging in MGST2-Gene-Deficient Mice. Biomedicines 2024; 12:370. [PMID: 38397974 PMCID: PMC10887158 DOI: 10.3390/biomedicines12020370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/23/2024] [Accepted: 02/01/2024] [Indexed: 02/25/2024] Open
Abstract
Strabismus, a neuro-ophthalmological condition characterized by misalignment of the eyes, is a common ophthalmic disorder affecting both children and adults. In our previous study, we identified the microsomal glutathione S-transferase 2 (MGST2) gene as one of the potential candidates for comitant strabismus susceptibility in a Japanese population. The MGST2 gene belongs to the membrane-associated protein involved in the generation of pro-inflammatory mediators, and it is also found in the protection against oxidative stress by decreasing the reactivity of oxidized lipids. To look for the roles of the MGST2 gene in the development, eye alignment, and overall morphology of the eye as the possible background of strabismus, MGST2 gene knockout (KO) mice were generated by CRISPR/Cas9-mediated gene editing with guide RNAs targeting the MGST2 exon 2. The ocular morphology of the KO mice was analyzed through high-resolution images obtained by a magnetic resonance imaging (MRI) machine for small animals. The morphometric analyses showed that the height, width, and volume of the eyeballs in MGST2 KO homozygous mice were significantly greater than those of wild-type mice, indicating that the eyes of MGST2 KO homozygous mice were significantly enlarged. There were no significant differences in the axis length and axis angle. These morphological changes may potentially contribute to the development of a subgroup of strabismus.
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Affiliation(s)
- Chaomulige
- Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama 700-8558, Japan;
| | - Toshihiko Matsuo
- Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama 700-8558, Japan;
- Department of Ophthalmology, Okayama University Hospital, Okayama 700-8558, Japan
| | - Kohei Sugimoto
- Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama 700-8558, Japan;
| | - Mary Miyaji
- Department of Medical Neurobiology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Okayama 700-8558, Japan; (M.M.); (O.H.)
| | - Osamu Hosoya
- Department of Medical Neurobiology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Okayama 700-8558, Japan; (M.M.); (O.H.)
| | - Masashi Ueda
- Department of Biofunctional Imaging Analysis, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Okayama 700-8530, Japan;
| | - Ryosuke Kobayashi
- Biosignal Genome Resource Center, Institute for Molecular and Cellular Regulation, Gunma University, Maebashi 371-8512, Japan; (R.K.); (T.H.); (I.H.)
| | - Takuro Horii
- Biosignal Genome Resource Center, Institute for Molecular and Cellular Regulation, Gunma University, Maebashi 371-8512, Japan; (R.K.); (T.H.); (I.H.)
| | - Izuho Hatada
- Biosignal Genome Resource Center, Institute for Molecular and Cellular Regulation, Gunma University, Maebashi 371-8512, Japan; (R.K.); (T.H.); (I.H.)
- Viral Vector Core, Gunma University Initiative for Advanced Research (GIAR), Maebashi 371-8511, Japan
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Kraft J, Lutyj P, Grabenbauer F, Ströhle SP, Tamihardja J, Razinskas G, Weick S, Richter A, Huflage H, Wittig A, Flentje M, Lisowski D. Assessment of dual-energy computed tomography derived virtual monoenergetic imaging for target volume delineation of brain metastases. Radiother Oncol 2023; 187:109840. [PMID: 37536377 DOI: 10.1016/j.radonc.2023.109840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 07/21/2023] [Accepted: 07/24/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND Objective and subjective assessment of image quality of brain metastases on dual-energy computed tomography (DECT) virtual monoenergetic imaging (VMI) and its impact on target volume delineation. MATERIALS AND METHODS 26 patients with 37 brain metastases receiving Magnetic Resonance Imaging (MRI) and DECT for stereotactic radiotherapy planning were included in this retrospective analysis. Lesion contrast (LC), contrast-to-noise ratio (CNR) and signal-to-noise ratio (SNR) were assessed for reconstructed VMI at 63 keV and artificial 120 kV Computed Tomography (CT). Image contrast and demarcation of metastases between 120 kV CT, VMI and MRI were subjectively assessed. Brain metastases were delineated by four radiation oncologists on VMI with a fixed or free brain window and contours were compared to solely MRI-based delineation using the Dice similarity coefficient. RESULTS LC, CNR and SNR were significantly higher in VMI than in 120 kV CT (p < 0.0001). Image contrast and lesion demarcation were significantly better on VMI compared to 120 kV CT (p < 0.0001). Mean gross tumor volume (GTV)/planning target volume (PTV) Dice similarity coefficients were 0.87/0.9 for metastases without imaging uncertainties (no artifacts, calcification or impaired visibility with MRI) but worse for metastases with imaging uncertainties (0.71/0.74). Target volumes delineated on VMI were around 5-10% smaller compared to MRI. CONCLUSION Image quality of VMI is objectively and subjectively superior to conventional CT. VMI provides significant advantages in stereotactic radiotherapy planning with improved visibility of brain metastases and geometrically distortion-free representation of brain metastases. Beside a plausibility check of MRI-based target volume delineation, VMI might improve reliability and accuracy in target volume definition particularly in cases with imaging uncertainties with MRI.
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Affiliation(s)
- Johannes Kraft
- Department of Radiation Oncology, University Hospital Wuerzburg, Wuerzburg, Germany.
| | - Paul Lutyj
- Department of Radiation Oncology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Felix Grabenbauer
- Department of Radiation Oncology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Serge-Peer Ströhle
- Department of Radiation Oncology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Jörg Tamihardja
- Department of Radiation Oncology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Gary Razinskas
- Department of Radiation Oncology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Stefan Weick
- Department of Radiation Oncology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Anne Richter
- Department of Radiation Oncology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Henner Huflage
- Department of Diagnostic and Interventional Radiology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Andrea Wittig
- Department of Radiation Oncology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Michael Flentje
- Department of Radiation Oncology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Dominik Lisowski
- Department of Radiation Oncology, University Hospital Wuerzburg, Wuerzburg, Germany
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Kumagai M, Kawamura M, Kato Y, Okudaira K, Naganawa S. The Impact of System-Related Magnetic Resonance Imaging Geometric Distortion in Stereotactic Radiotherapy: A Case Report. Cureus 2022; 14:e27269. [PMID: 36039267 PMCID: PMC9403780 DOI: 10.7759/cureus.27269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2022] [Indexed: 11/05/2022] Open
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