Kolumbán Zsuzsa, Viola Arpád, Major Tibor, Bajzik Gábor, Julow Jeno
Fôvárosi Onkormányzat, Szent János Kórház és Rendelôintézet, Idegsebészeti Osztály, Budapest.
Ideggyogy Sz. 2008 Mar 30;61(3-4):106-13.
The aim of this study is to reveal the volumetric changes in tumor necrosis, reactive zone and edema following low-dose rate 1-125 interstitial irradiation of 20 inoperable (partially non-resectable, partially inoperable) low-grade gliomas.
The volumes of the three regions on image-fused control CT/MRI images were measured for a 24-month period with 36 occasions. The delivered dose on the tumor surface (GTV) was 50-60 Gy. Dose planning and image fusion were performed with the BrainLab Target 1.19 software, mathematical and statistical computations were carried out with the Matlab Numeric Computation and Visualization software. The control images with the "triple ring" were fused with the planning images, and the isodose curves were adjusted to them.
Relative volumes normalized to volume of the reference dose were calculated and plotted in the time domain. The mean values of volumes were determined from the patients' measured data then a polynom was fitted to the mean values using the polynomial curve fitting method. The accuracy of our results were verified by statistical tools.
The new polynomial prediction approach using image fusion analysis of the volume of tumor necrosis, reactive ring and edema caused by interstitial irradiation as a function of time provides valuable information for 1. selecting the best patient's treatment option, 2. following up patient's condition and 3. planning reirradiation or reoperation if necessary.
本研究旨在揭示20例无法手术（部分不可切除、部分无法手术）的低级别胶质瘤在进行低剂量率¹²⁵I组织间照射后，肿瘤坏死区、反应区和水肿区的体积变化。
在24个月内，对图像融合的对照CT/MRI图像上的三个区域的体积进行了36次测量。肿瘤表面（GTV）的照射剂量为50 - 60 Gy。使用BrainLab Target 1.19软件进行剂量规划和图像融合，使用Matlab数值计算与可视化软件进行数学和统计计算。将带有“三环”的对照图像与规划图像融合，并根据对照图像调整等剂量曲线。
计算了相对于参考剂量体积归一化后的相对体积，并在时域中绘制。根据患者的测量数据确定体积的平均值，然后使用多项式曲线拟合方法将多项式拟合到平均值上。我们结果的准确性通过统计工具进行了验证。
利用图像融合分析组织间照射引起的肿瘤坏死、反应环和水肿体积随时间变化的新多项式预测方法，为以下方面提供了有价值的信息：1. 选择最佳的患者治疗方案；2. 跟踪患者病情；3. 必要时规划再次照射或再次手术。
