1
|
Wilson LJ, Davey A, Vasquez Osorio E, Faught AM, Green A, Bulbeck H, Thomson A, Goddard J, McCabe MG, Merchant TE, van Herk M, Aznar MC. CT- and MR-based image-based data mining are consistent in the brain. Phys Med 2024; 125:104503. [PMID: 39197263 DOI: 10.1016/j.ejmp.2024.104503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 06/17/2024] [Accepted: 08/22/2024] [Indexed: 09/01/2024] Open
Abstract
PURPOSE Image-based data mining (IBDM) is a voxel-based analysis technique to investigate dose-response. Most often, IBDM uses radiotherapy planning CTs because of their broad accessibility, however, it was unknown whether CT provided sufficient soft tissue contrast for brain IBDM. This study evaluates whether MR-based IBDM improves upon CT-based IBDM for studies of children with brain tumours. METHODS We compared IBDM pipelines using either CT- or MRI-based spatial normalisation in 128 children (ages 3.3-19.7 years) who received photon radiotherapy for primary brain tumours at a single institution. We quantified spatial-normalisation accuracy using contour comparison measures (centre-of-mass separation, average contour distance-to-agreement (DTavg), and Hausdorff distance) at multiple anatomic loci. We performed an end-to-end test of CT- and MRI-IBDM using modified clinical dose distributions and simulated effect labels to detect associations in pre-defined anatomic loci. Accuracy was assessed via sensitivity and specificity. RESULTS Spatial normalisation accuracy was comparable for both modalities, with a significant but small improvement for MRI compared to CT in all structures except the brainstem. The median (range) difference between the DTavg for the two pipelines was 0.37 (0.00-2.91) mm. The end-to-end test revealed no significant difference in sensitivity of the IBDM-identified regions for the two pipelines. Specificity slightly improved for MR-IBDM at the 99% significance level. CONCLUSION CT-based IBDM was comparable to MR-based IBDM, despite a small advantage in spatial normalisation accuracy with MRI. The use of CT-IBDM over MR-IBDM is useful for multi-institutional retrospective IBDM studies, where the availability of standardised MRI data can be limited.
Collapse
Affiliation(s)
- Lydia J Wilson
- St Jude Children's Research Hospital, Department of Radiation Oncology, Memphis, TN, USA
| | - Angela Davey
- Division of Cancer Sciences, Faculty of Biology Medicine and Health, The University of Manchester, Manchester, UK.
| | - Eliana Vasquez Osorio
- Division of Cancer Sciences, Faculty of Biology Medicine and Health, The University of Manchester, Manchester, UK
| | - Austin M Faught
- St Jude Children's Research Hospital, Department of Radiation Oncology, Memphis, TN, USA
| | - Andrew Green
- Division of Cancer Sciences, Faculty of Biology Medicine and Health, The University of Manchester, Manchester, UK
| | | | - Adam Thomson
- Brainstrust - The Brain Cancer People, Cowes, UK
| | - Josh Goddard
- Brainstrust - The Brain Cancer People, Cowes, UK
| | - Martin G McCabe
- Division of Cancer Sciences, Faculty of Biology Medicine and Health, The University of Manchester, Manchester, UK; The Christie NHS Foundation Trust, Manchester, UK
| | - Thomas E Merchant
- St Jude Children's Research Hospital, Department of Radiation Oncology, Memphis, TN, USA
| | - Marcel van Herk
- Division of Cancer Sciences, Faculty of Biology Medicine and Health, The University of Manchester, Manchester, UK
| | - Marianne C Aznar
- Division of Cancer Sciences, Faculty of Biology Medicine and Health, The University of Manchester, Manchester, UK
| |
Collapse
|
2
|
Shapey J, Vos SB, Mancini L, Sanders B, Thornton JS, Tournier JD, Saeed SR, Kitchen N, Khalil S, Grover P, Bradford R, Dorent R, Sparks R, Vercauteren T, Yousry T, Bisdas S, Ourselin S. Diffusion MRI of the facial-vestibulocochlear nerve complex: a prospective clinical validation study. Eur Radiol 2023; 33:8067-8076. [PMID: 37328641 PMCID: PMC10598116 DOI: 10.1007/s00330-023-09736-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 02/08/2023] [Accepted: 03/12/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVES Surgical planning of vestibular schwannoma surgery would benefit greatly from a robust method of delineating the facial-vestibulocochlear nerve complex with respect to the tumour. This study aimed to optimise a multi-shell readout-segmented diffusion-weighted imaging (rs-DWI) protocol and develop a novel post-processing pipeline to delineate the facial-vestibulocochlear complex within the skull base region, evaluating its accuracy intraoperatively using neuronavigation and tracked electrophysiological recordings. METHODS In a prospective study of five healthy volunteers and five patients who underwent vestibular schwannoma surgery, rs-DWI was performed and colour tissue maps (CTM) and probabilistic tractography of the cranial nerves were generated. In patients, the average symmetric surface distance (ASSD) and 95% Hausdorff distance (HD-95) were calculated with reference to the neuroradiologist-approved facial nerve segmentation. The accuracy of patient results was assessed intraoperatively using neuronavigation and tracked electrophysiological recordings. RESULTS Using CTM alone, the facial-vestibulocochlear complex of healthy volunteer subjects was visualised on 9/10 sides. CTM were generated in all 5 patients with vestibular schwannoma enabling the facial nerve to be accurately identified preoperatively. The mean ASSD between the annotators' two segmentations was 1.11 mm (SD 0.40) and the mean HD-95 was 4.62 mm (SD 1.78). The median distance from the nerve segmentation to a positive stimulation point was 1.21 mm (IQR 0.81-3.27 mm) and 2.03 mm (IQR 0.99-3.84 mm) for the two annotators, respectively. CONCLUSIONS rs-DWI may be used to acquire dMRI data of the cranial nerves within the posterior fossa. CLINICAL RELEVANCE STATEMENT Readout-segmented diffusion-weighted imaging and colour tissue mapping provide 1-2 mm spatially accurate imaging of the facial-vestibulocochlear nerve complex, enabling accurate preoperative localisation of the facial nerve. This study evaluated the technique in 5 healthy volunteers and 5 patients with vestibular schwannoma. KEY POINTS • Readout-segmented diffusion-weighted imaging (rs-DWI) with colour tissue mapping (CTM) visualised the facial-vestibulocochlear nerve complex on 9/10 sides in 5 healthy volunteer subjects. • Using rs-DWI and CTM, the facial nerve was visualised in all 5 patients with vestibular schwannoma and within 1.21-2.03 mm of the nerve's true intraoperative location. • Reproducible results were obtained on different scanners.
Collapse
Affiliation(s)
- Jonathan Shapey
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK.
- Department of Neurosurgery, King's College Hospital, London, UK.
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London, UK.
| | - Sjoerd B Vos
- Centre for Medical Image Computing, University College London, London, UK
- Neuroradiological Academic Unit, UCL Institute of Neurology, London, UK
| | - Laura Mancini
- Neuroradiological Academic Unit, UCL Institute of Neurology, London, UK
- Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Brett Sanders
- Department of Neurophysiology, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - John S Thornton
- Neuroradiological Academic Unit, UCL Institute of Neurology, London, UK
- Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | | | - Shakeel R Saeed
- Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
- The Ear Institute, University College London, London, UK
- The Royal National Throat, Nose and Ear Hospital, London, UK
| | - Neil Kitchen
- Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Sherif Khalil
- Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
- The Royal National Throat, Nose and Ear Hospital, London, UK
| | - Patrick Grover
- Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Robert Bradford
- Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Reuben Dorent
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Rachel Sparks
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Tom Vercauteren
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Tarek Yousry
- Neuroradiological Academic Unit, UCL Institute of Neurology, London, UK
- Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Sotirios Bisdas
- Neuroradiological Academic Unit, UCL Institute of Neurology, London, UK
- Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Sebastien Ourselin
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| |
Collapse
|
3
|
Konopka-Filippow M, Hempel D, Sierko E. Actual, Personalized Approaches to Preserve Cognitive Functions in Brain Metastases Breast Cancer Patients. Cancers (Basel) 2022; 14:3119. [PMID: 35804894 PMCID: PMC9265102 DOI: 10.3390/cancers14133119] [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: 05/19/2022] [Revised: 06/14/2022] [Accepted: 06/15/2022] [Indexed: 11/24/2022] Open
Abstract
Breast cancer (BC) is the most often diagnosed cancer among women worldwide and second most common cause of brain metastases (BMs) among solid malignancies being responsible for 10-16% of all BMs in oncological patients. Moreover, BMs are associated with worse prognosis than systemic metastases. The quality of life (QoL) among brain metastases breast cancer (BMBC) patients is significantly influenced by cognitive functions. Cancer-related cognitive deficits and the underlying neural deficits in BMBC patients can be caused via BMs per se, chemotherapy administration, brain irradiation, postmenopausal status, or comorbidities. Brain RT often leads to cognitive function impairment by damage of neural progenitor cells of the hippocampus and hence decreased QoL. Sparing the hippocampal region of the brain during RT provides protective covering of the centrally located hippocampi according to the patient's clinical requirements. This article discusses the personalized strategies for treatment options to protect cognitive functions in BMBC patients, with special emphasis on the innovative techniques of radiation therapy.
Collapse
Affiliation(s)
- Monika Konopka-Filippow
- Department of Oncology, Medical University of Bialystok, 15-274 Bialystok, Poland; (M.K.-F.); (D.H.)
- Department of Radiotherapy I, Maria Sklodowska-Curie Bialystok Oncology Centre, 15-027 Bialystok, Poland
| | - Dominika Hempel
- Department of Oncology, Medical University of Bialystok, 15-274 Bialystok, Poland; (M.K.-F.); (D.H.)
- Department of Radiotherapy I, Maria Sklodowska-Curie Bialystok Oncology Centre, 15-027 Bialystok, Poland
| | - Ewa Sierko
- Department of Oncology, Medical University of Bialystok, 15-274 Bialystok, Poland; (M.K.-F.); (D.H.)
- Department of Radiotherapy I, Maria Sklodowska-Curie Bialystok Oncology Centre, 15-027 Bialystok, Poland
| |
Collapse
|