Hamilton R J, Sweeney P J, Pelizzari C A, Yetkin F Z, Holman B L, Garada B, Weichselbaum R R, Chen G T
Department of Radiation and Cellular Oncology, University of Chicago, IL 60637, USA.
Int J Radiat Oncol Biol Phys. 1997 Jan 1;37(1):181-8. doi: 10.1016/s0360-3016(96)00475-0.
Explore the use of functional imaging data in radiation treatment planning of brain lesions.
Compare the treatment-planning process with and without the use of functional brain imaging for clinical cases where functional studies using either single photon emission computed tomography or magnetic resonance imaging are available.
A method to register functional image data with planning image studies is needed for functional treatment planning. Functional volumes are not simply connected regions. One activation study may produce many isolated functional areas. After finding the functional volumes and registering the functional information with the planning imaging data, the tools used for conventional three-dimensional treatment planning are sufficient for functional treatment planning. However, the planning system must provide dose-volume histograms for volumes of interest that consist of isolated pieces. Treatment plans that spare functional brain while providing identical target coverage can be constructed for lesions situated near the functional volume. However, the dose to other areas of the brain may be increased.
Functional imaging will make determination of dose response of eloquent areas of the brain possible when combined with volumetric dose information and neuropsychological evaluation prior to and after radiation therapy. Realizing the full potential of functional imaging studies will require improved delineation of activated volumes and determination of the uncertainties in functional volume delineation. Optimization of treatment plans by minimizing dose to volumes activated during functional imaging studies should be used cautiously, because the dose to "silent," but possibly eloquent, brain may be increased.
探讨功能成像数据在脑病变放射治疗计划中的应用。
对于可获得使用单光子发射计算机断层扫描或磁共振成像进行功能研究的临床病例，比较使用和不使用脑功能成像的治疗计划过程。
功能治疗计划需要一种将功能图像数据与计划图像研究进行配准的方法。功能体积并非简单的连通区域。一项激活研究可能会产生许多孤立的功能区域。在找到功能体积并将功能信息与计划成像数据配准后，用于传统三维治疗计划的工具足以进行功能治疗计划。然而，计划系统必须为由孤立部分组成的感兴趣体积提供剂量体积直方图。对于位于功能体积附近的病变，可以构建在提供相同靶区覆盖的同时 sparing 脑功能的治疗计划。然而，脑的其他区域的剂量可能会增加。
功能成像与放疗前后的体积剂量信息及神经心理学评估相结合，将使确定脑功能区的剂量反应成为可能。要充分发挥功能成像研究的潜力，需要改进激活体积的勾画以及确定功能体积勾画中的不确定性。通过最小化功能成像研究期间激活体积的剂量来优化治疗计划时应谨慎使用，因为对“沉默”但可能有功能的脑区的剂量可能会增加。
