Sun Lu, Qu Baolin, Wang Jinyuan, Ju Zhongjian, Zhang Zizhong, Cui Zhiqiang, Jack Yang, Ling Zhipei, Yu Xinguang, Pan Longsheng
Department of Neurosurgery, PLA General Hospital, Beijing, China.
Department of Radiation Oncology, PLA General Hospital, Beijing, China.
Technol Cancer Res Treat. 2017 Dec;16(6):850-856. doi: 10.1177/1533034617705283. Epub 2017 Apr 20.
To investigate the efficacy of the integration of functional magnetic resonance imaging and diffusion-tensor imaging tractography data into CyberKnife radiosurgery for intracranial tumor management.
Functional neuroimaging, anatomical magnetic resonance imaging, and computed tomography images of patients with brain lesions in critical areas were acquired before radiosurgery. The acquired data sets were coregistered using the MIM image fusion software module and then were imported into the CyberKnife Robotic Radiosurgery System (Multiplan 4.0.2) for delineating the target, organs at risk, and possible nearby functionally relevant cortical and subcortical areas. Radiation dose distributions with and without the functionally relevant cortical and subcortical areas into the optimization process were developed and compared.
There were significant differences between the treatment plans with and without the functionally relevant cortical and subcortical areas into the optimization process. An average 22.71% reduction in the maximum dose to functional areas was observed. No neurological complication due to radiation damage was observed in the follow-up period.
The functional neuroimaging could be easily and reliably integrated into the CyberKnife treatment planning. Consideration of functional structures and fiber tracts during treatment planning could clinically reduce the radiation doses to these critical structures, thereby preserving its unique function of brain.
研究将功能磁共振成像和弥散张量成像纤维束示踪数据整合到射波刀放射外科治疗颅内肿瘤中的疗效。
在放射外科治疗前，获取关键区域脑病变患者的功能神经成像、解剖磁共振成像和计算机断层扫描图像。使用MIM图像融合软件模块对获取的数据集进行配准，然后导入射波刀机器人放射外科系统（Multiplan 4.0.2），用于勾画靶区、危及器官以及可能的附近功能相关皮质和皮质下区域。制定并比较了优化过程中纳入和未纳入功能相关皮质和皮质下区域的放射剂量分布。
优化过程中纳入和未纳入功能相关皮质和皮质下区域的治疗计划之间存在显著差异。观察到功能区的最大剂量平均降低了22.71%。随访期间未观察到因辐射损伤导致的神经并发症。
功能神经成像能够轻松且可靠地整合到射波刀治疗计划中。治疗计划过程中考虑功能结构和纤维束可在临床上降低对这些关键结构的放射剂量，从而保留其独特的脑功能。
