Evaluation of the Impact of Magnetic Resonance Imaging (MRI) on Gross Tumor Volume (GTV) Definition for Radiation Treatment Planning (RTP) of Inoperable High Grade Gliomas (HGGs)

Abstract

Aim and Background. Inoperable high-grade gliomas (HGGs) comprise a specific group of brain tumors portending a very poor prognosis. In the absence of surgical management, radiation therapy (RT) offers the primary local treatment modality for inoperable HGGs. Optimal target definition for radiation treatment planning (RTP) of HGGs is a difficult task given the diffusely infiltrative nature of the disease. In this context, detailed multimodality imaging information may add to the accuracy of target definition in HGGs. We evaluated the impact of Magnetic Resonance Imaging (MRI) on Gross Tumor Volume (GTV) definition for RTP of inoperable HGGs in this study. Materials and Methods. Twenty-five inoperable patients with a clinical diagnosis of HGG were included in the study. GTV definition was based on Computed Tomography- (CT-) simulation images only or both CT-simulation and MR images, and a comparative assessment was performed to investigate the incorporation of MRI into RTP of HGGs. Results. Median volume of GTV acquired by using CT-simulation images only and by use of CT and MR images was 65.3 (39.6-94.3) cc and 76.1 (46.8-108.9) cc, respectively. Incorporation of MRI into GTV definition has resulted in a median increase of 12.61% (6%-19%) in the volume of GTV defined by using the CT-simulation images only, which was statistically significant (p < 0.05). Conclusion. Incorporation of MRI into RTP of inoperable HGGs may improve GTV definition and may have implications for dose escalation/intensification strategies despite the need for further supporting evidence.

Evaluation of Radiosurgery Target Volume Definition for Tectal Gliomas with Incorporation of Magnetic Resonance Imaging (MRI): An Original Article

“…Utility of multimodality imaging for radiosurgery treatment planning for tectal gliomas has been poorly addressed in the literature. In this context, our study adds to the existing literature and supports the incorporation of MRI for improved radiosurgery treatment planning for tectal gliomas consistent with another studies [48][49][50][51][52][53][54][55][56][57][58][59].…”

Utility of Multimodality Imaging Based Target Volume Definition for Radiosurgery of Trigeminal Neuralgia: An Original Article

“…In this study, we assessed incorporation of multimodality imaging into target volume definition of trigeminal neuralgia radiosurgery. Indeed, usefulness of neuroimaging with MRI for definition of central nervous system radiotherapy and radiosurgery target volumes has been an important focus of research in the literature [40][41][42][43][44][45][46][47][48][49]. Our results appear to be compatible to these studies supporting the incorporation of MRI in radiosurgery treatment planning.…”

Determination of Radiosurgery Treatment Volume for Intracranial Germ Cell Tumors (GCTS)

“…In this context, multimodality imaging may add to the accuracy of target definition for radiosurgery of intracranial GCTs. Indeed several other studies have demonstrated refined treatment volume determination by including MRI to the process of target determination [39][40][41][42][43][44][45][46][47][48][49][50][51].…”