Abstract
Purpose
To assess the differences between the target delineation using computed tomography (CT) and imaging fusion CT/magnetic resonance imaging (MRI) for the radiotherapy planning of glioblastoma.
Methods
One hundred-twenty gross tumor volume and clinical target volume on CT and MRI (GTVCT/CTVCT, GTVMRI/CTVMRI, respectively) were contoured and evaluated. The treatments planning (total dose 60 Gy) based on CTVCT were analysed in terms of percentage of CTVCT and CTVMRI receiving 95 % of the prescribed dose (V95-CTVCT, V95-CTVMRI).
Results
GTVs and CTVs contoured on MRI were significantly larger than those delineated on CT (p = 0.0003, p = 0.0006, respectively). Nighty-two percent of CTVCT was coincident with the CTVMRI and 8 % was normal tissue; 20 % of CTVMRI, considered as tumor volume, was not included on CTVCT. The V95-CTVMRI was significantly lower than the V95-CTVCT (p = 0.0005).
Conclusions
In the delineation of glioblastoma target volume, fusion CT/MRI was preferred. The CT only is insufficient for the CTV dose coverage.
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References
Stupp R, Hegi ME, Mason WP et al (2009) Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-year analysis of the EORTC-NCIC trial. Lancet Oncol 10(5):459–466
Balducci M, Chiesa S, Diletto B et al (2012) Low-dose fractionated radiotherapy and concomitant chemotherapy in glioblastoma multiforme with poor prognosis: a feasibility study. Neuro Oncol 14(1):79–86
Balducci M, Apicella G, Manfrida S et al (2010) Single-arm phase II study of conformal radiation therapy and temozolomide plus fractionated stereotactic conformal boost in high grade gliomas. Strahlen Onkol 186(10):558–564
Baumert BG, Brada M, Bernier J et al (2008) EORTC 22972–26991/MRC BR10 trial: fractionated stereotactic boost following conventional radiotherapy of high grade gliomas. Clinical and quality assurance results of the stereotactic boost arm. Radiother Oncol 88:163–172
Balducci M, Fiorentino A, De Bonis P et al (2012) Impact of age and co-morbidities in patients with newly diagnosed glioblastoma: a pooled data analysis of three prospective mono-institutional phase II studies. Med Oncol 29(5):3478–3483. doi:10.1007/s12032-012-0263-3
Chan JL, Lee SW, Fraass BA et al (2002) Survival and failure patterns of high-grade gliomas after three-dimensional conformal radiotherapy. J Clin Oncol 20:1635–1642
Aydin H, Sillenberg I, von Lieven H (2001) Patterns of failure following CT-based 3-D irradiation for malignant glioma. Strahlenther Onkol 177:424–431
Chang EL, Akyurek S, Avalos T et al (2007) Evaluation of peritumoral edema in the delineation of radiotherapy clinical target volumes for glioblastoma. Int J Radiat Oncol Biol Phys 68:144–150
Oppitz U, Maessen D, Zunterer H, Richter S, Flentje M (1999) 3-D recurrence patterns of glioblastomas after CT-planned postoperative irradiation. Radiother Oncol 53:53–57
Hochberg FH, Pruitt A (1980) Assumptions in the radiotherapy of glioblastoma. Neurology 30:907–911
Farace P, Giri MG, Meliadò G et al (2011) Clinical target volume delineation in glioblastomas: pre-operative versus post-operative/pre-radiotherapy MRI. British J Radiol 84:271–278
Weber DC, Wangi H, Albrecht S et al (2008) Open low-field magnetic resonance imaging for target definition, dose calculation and set-up verification during three-dimensional CRT fo glioblastoma multiform. Clin Oncol 20:157–167
Krempien RC, Schubert K, Zierhut D et al (2002) Open low-field magnetic resonance imaging in radiation therapy treatment planning. Int J Radiat Oncol Biol Phys 53:1350–1360
Thornton AF Jr, Sandler HM, Ten Haken RK et al (1992) The clinical utility of magnetic resonance imaging in 3-dimensional treatment planning of brain neoplasms. Int J Radiat Oncol Biol Phys 24:767–775
Just M, Rosler HP, Higer HP et al (1991) MRI-assisted radiation therapy planning of brain tumors clinical experiences in 17 patients. Magn Reson Imaging 9:173–177
Lawrence YR, Li XA, el Naqa I et al (2010) Radiation dose-volume effects in the brain. Int J Radiat Oncol Biol Phys 76(3 Suppl):S20–S27
Halperin EC, Bentel G, Heinz ER, Burger PC (1989) Radiation therapy treatment planning in supratentorial glioblastoma multiforme: an analysis based on post mortem topographic anatomy with CT correlations. Int J Radiat Oncol Biol Phys 17:1347–1350
Minniti G, Amelio D, Amichetti M et al (2010) Patterns of failure and comparison of different target volume delineations in patients with glioblastoma treated with conformal radiotherapy plus concomitant and adjuvant temozolomide. Radiother Oncol 97(3):377–381
Lattanzi JP, Fein DA, McNeeley SW et al (1997) Computed tomography-magnetic resonance image fusion: a clinical evaluation of an innovative approach for improved tumor localization in primary central nervous system lesions. Radiat Oncol Investig 5:195–205
Myrianthopoulos LC, Vijayakumar S, Spelbring DR et al (1992) Quantitation of treatment volumes from CT and MRI in high grade gliomas: implications for radiotherapy. Magn Reson Imaging 10:375–383
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We gratefully acknowledge Filippo Fiorentino for his support in the revision of this manuscript.
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Fiorentino, A., Caivano, R., Pedicini, P. et al. Clinical target volume definition for glioblastoma radiotherapy planning: magnetic resonance imaging and computed tomography. Clin Transl Oncol 15, 754–758 (2013). https://doi.org/10.1007/s12094-012-0992-y
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DOI: https://doi.org/10.1007/s12094-012-0992-y