Functional imaging in treatment planning of brain lesions

Hamilton, Rex; Sweeney, Patrick J.; Pelizzari, Charles A.; Yetkin, Funda; Holman, B.L.; Garada, B; Weichselbaum, Ralph R.; Chen, G.T.Y.

doi:10.1016/s0360-3016(96)00475-0

Cited by 52 publications

(15 citation statements)

References 30 publications

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“…Noninvasive mapping of brain function can be achieved with such methods as magnetoencephalography [6], positron emission tomography [7], single photon emission computed tomography (SPECT) [8], somatosensory evoked potential dipole tracking [9] and fMRI [10]. The latter technique has certain advantages, including the relative availability of the scanner, the demonstrated robustness of motor and visual paradigms, the possibility of performing a necessary diagnostic/ stereotactic MRI at the same session and the demonstrated spatial accuracy of the registered functional maps [5,9].…”

Section: Discussionmentioning

confidence: 99%

“…Hamilton et al [8] first described the incorporation of data from fMRI (and SPECT) for SRS planning in 2 patients, using the activation maps to shape the treatment volume away from an adjacent functional area (motor in 1 patient and speech in the other) [8]. We employed the dose-volume histogram tool to measure the dose to specific volumes, multiple in 5 patients, to assess the impact of the registered fMRI on the treatment plans.…”

Section: Discussionmentioning

confidence: 99%

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Functional Magnetic Resonance Imaging and Radiosurgical Dose Planning

Schulder

Vega

Narra

et al. 1999

Stereotact Funct Neurosurg

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Objective: To assess the effect of functional magnetic resonance imaging (fMRI) on stereotactic radiosurgical (SRS) dose planning. Methods: Patients included those undergoing SRS whose lesions were in or near areas that could be identified with fMRI. After processing, an fMR scan was registered to the anatomic scan, and this dataset was registered to a stereotactic CT scan. The imaged functional areas were contoured along with standard anatomical targets. Dose planning was done at first with the functional volumes rendered invisible; the plans were then adjusted as needed using the functional targets. Doses were measured using a dose-volume histogram tool. Results: SRS was performed in 12 patients, 1 of whom also underwent SRT. Functional volumes studied included motor cortex in 8 patients, visual in 6 and language in 3; a total of 33 functional targets were imaged. Prescription doses ranged from 12 to 22.5 Gy (mean 19.5 Gy), and the maximum dose to functional volumes from 8 cGy to 18.5 Gy (mean 2.9 Gy). In 6 patients, arc adjustment using functional targets yielded a >50% reduction in dose to at least one functional volume; in all patients, the dose reduction to 50 and 75% of functional volumes averaged 4% (12 cGy) and 13% (30 cGy), respectively, while the reduction of maximal dose averaged 24% (50 cGy). Conclusions: fMRI can be used in SRS to reduce irradiation of eloquent brain using standard prescription doses. Appropriate arc adjustment may allow for escalation of the dose to the targeted lesion.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Functional Magnetic Resonance Imaging and Radiosurgical Dose Planning

Schulder

Vega

Narra

et al. 1999

Stereotact Funct Neurosurg

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“…The authors conclude that F-MRI may prove to be a useful adjunct to radiotherapy, especially if the patient is regularly controlled by means of this technique. The members of another group exploring the use of functional imaging data in radiation treatment planning of brain lesions take a more skeptical view of its potential clinical benefit [17].…”

Section: Bold F-mri In Radiotherapymentioning

confidence: 99%

Functional Magnetic Resonance Imaging – Basics and Applications in Oncology

Golder

2002

Oncol Res Treat

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Functional MR imaging (F-MRI) permits to visualize active processes evolving in the human brain. The shifts in blood oxygenation following local neuronal activation are used for generating an MR signal. Specific procedural problems have to be solved when using F-MRI in patients with brain neoplasms. The relationship between perirolandic tumors and the adjacent motor areas has been studied most intensively. When the resection of tumors in the motor area is considered, functional imaging can help the surgeon to avoid or at least to minimize postoperative functional deficits. Overall, F-MRI study results are useful in at least one crucial preoperative decision step for about 90% of brain tumor patients. Experience with functional imaging in radiotherapy of brain neoplasms is still limited. Presently, F-MRI cannot yet replace intraoperative brain mapping.

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“…At the same time, the limitations of 'traditional', intraoperative methods of brain mapping have fueled the development of noninvasive ways to image the functional cortex, including functional magnetic resonance imaging (fMRI) [1], positron emission tomography [2], single photon emission computed tomography (SPECT) [3], and magnetoencephalography (MEG) [4]. Several authors have taken these technologies to the next logical step, namely incorporation of preoperative, stereotactic functional imaging data into the frameless stereotactic environment.…”

Section: Introductionmentioning

confidence: 99%

Functional Magnetic Resonance Image-Guided Surgery of Tumors in or near the Primary Visual Cortex

Schulder¹,

Holodny²,

Liu³

et al. 1999

Stereotact Funct Neurosurg

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Objective: To assess the accuracy of functional magnetic resonance imaging (fMRI) of the primary visual cortex in patients undergoing surgery for tumors in the occipital lobe. Methods: Two patients with nondominant occipital lobe tumors were studied, one with a solitary lung metastasis and another with radiation necrosis after radiosurgery for a low-grade astrocytoma. At surgery, visual evoked potentials (VEPs) were stimulated using Light-emitting-diode goggles and recorded using cortical grids placed immediately after brain exposure. The location of the peak VEP was compared to that predicted by the registered functional scan. Results: In each case, the epicenter of visual activation as represented on the registered fMRI corresponded to the site of peak VEP recording. Prediction error for the visual cortex, measured in patient 1, was 1.0 mm. Visual confirmation showed the registration in the second patient to be accurate as well. Conclusion: As previously demonstrated for sensorimotor fMRI, visual fMRI accurately predicts the location of the primary visual cortex. Additional confirmation is expected with more clinical experience.

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Functional imaging in treatment planning of brain lesions

Cited by 52 publications

References 30 publications

Functional Magnetic Resonance Imaging and Radiosurgical Dose Planning

Functional Magnetic Resonance Imaging and Radiosurgical Dose Planning

Functional Magnetic Resonance Imaging – Basics and Applications in Oncology

Functional Magnetic Resonance Image-Guided Surgery of Tumors in or near the Primary Visual Cortex

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