Recurrence analysis of glioblastoma cases based on distance and dose information

Langhans, Marco; Popp, Ilinca; Grosu, A.L.; Shusharina, Nadya; Binder, Harald; Baltas, Dimos; Bortfeld, Thomas

doi:10.1016/j.radonc.2023.109600

Cited by 6 publications

(2 citation statements)

References 21 publications

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“…A large migration distance in this context might indicate a less than conformal plan and the potential for plan improvement. Similarly, the migration distance might serve a role in recurrence analysis, 19 with the migration distance from the prescription dose volume to the recurrence volume a quantitative measure of the loco‐regional failure location.…”

Section: Discussionmentioning

confidence: 99%

Technical note: The migration distance – a unidirectional distance metric for region‐of‐interest comparisons

Stewart,

Sahgal,

Hudson

et al. 2023

Medical Physics

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BackgroundThe radiotherapy process relies on several metrics in determining a notion of “distance” from one three‐dimensional region‐of‐interest (ROI) to another. The majority are symmetric (or commutative) and do not contain information pertaining to directionality. Growth versus regression, for example, is not inherently distinguished by these metrics.PurposeThe purpose of this work was to formalize a unidirectional distance metric, motivated by radiotherapy margin concepts, which we term the migration distance. Informally, the migration distance from ROI X to Y is the minimum isotropic expansion of X such that Y is completely encompassed by the expansion. If Y is contained within X, the migration distance is negative with magnitude equal to the maximum isotropic contraction of X such that Y remains contained within contraction. The metric is demonstrated by quantifying glioblastoma interfraction target changes.MethodsAn explicit mathematical formulation of the migration distance is presented and contrasted with the related Hausdorff distance. The results are demonstrated for the gross tumor volume (GTV) dynamics of a glioblastoma cohort consisting of 111 patients that underwent standard chemoradiotherapy with offline MR imaging at planning, fraction 10, fraction 20, and 1‐month post radiotherapy.ResultsThe mean ± SD of the GTV migration distance relative to planning was 5.9 ± 3.9 mm at fraction 10, 6.2 ± 4.4 mm at fraction 20, and 7.9 ± 7.1 mm at 1‐month post radiotherapy. The maximum GTV migration distance across all patients at the same timepoints was 20.4, 20.7, and 45.5 mm, respectively.ConclusionsWe have proposed and demonstrated a unidirectional distance metric. The migration distance may have applications in the quantification of anatomical changes, planning target volume designs, and dosimetric radiotherapy plan assessment.

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Section: Discussionmentioning

confidence: 99%

Technical note: The migration distance – a unidirectional distance metric for region‐of‐interest comparisons

Stewart,

Sahgal,

Hudson

et al. 2023

Medical Physics

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“…Recent publications suggest that, based on recurrence patterns, the conventional 20 mm margin may be excessive and that overall margin reduction may provide clinical benefit (Langhans et al 2023, Mendoza et al 2023. In light of this evidence, the recent ASTRO-EANO guidelines for GBM treatment recommended a 15 mm margin instead of the 20 mm found in the older EORTC and RTOG guidelines.…”

Section: Impact Of Model Design and Parameter Sensitivitymentioning

confidence: 99%

The influence of anisotropy on the clinical target volume of brain tumor patients

Buti,

Ajdari,

Hochreuter

et al. 2024

Phys. Med. Biol.

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Objective. Current radiotherapy guidelines for glioma target volume definition recommend a uniform margin expansion from the gross tumor volume (GTV) to the clinical target volume (CTV), assuming uniform infiltration in the invaded brain tissue. However, glioma cells migrate preferentially along white matter tracts, suggesting that white matter directionality should be considered in anisotropic CTV expansion. We investigate two models of anisotropic CTV expansion and evaluate their clinical feasibility.Approach. To incorporate white matter directionality into the CTV, a diffusion tensor imaging (DTI) atlas is used. The DTI atlas consists of water diffusion tensors that are first spatially transformed into local tumor resistance tensors, also known as metric tensors, and secondly fed to a CTV expansion algorithm to generate anisotropic CTVs. Two models of spatial transformation are considered in the first step. The first model assumes that tumor cells experience reduced resistance parallel to the white matter fibers. The second model assumes that the anisotropy of tumor cell resistance is proportional to the anisotropy observed in DTI, with an "anisotropy weighting parameter" controlling the proportionality. The models are evaluated in a cohort of ten brain tumor patients.Main results. To evaluate the sensitivity of the model, a library of model-generated CTVs was computed by varying the resistance and anisotropy parameters. Our results indicate that the resistance coefficient had the most significant effect on the global shape of the CTV expansion by redistributing the target volume from potentially less involved gray matter to white matter tissue. In addition, the anisotropy weighting parameter proved useful in locally increasing CTV expansion in regions characterized by strong tissue directionality, such as near the corpus callosum.Significance. By incorporating anisotropy into the CTV expansion, this study is a step toward an interactive CTV definition that can assist physicians in incorporating neuroanatomy into a clinically optimized CTV.

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PRIDE: isotoxische Dosiseskalation beim Glioblastom

Bodensohn,

Büttner,

Niyazi

2024

Forum

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Recurrence analysis of glioblastoma cases based on distance and dose information

Cited by 6 publications

References 21 publications

Technical note: The migration distance – a unidirectional distance metric for region‐of‐interest comparisons

Technical note: The migration distance – a unidirectional distance metric for region‐of‐interest comparisons

The influence of anisotropy on the clinical target volume of brain tumor patients

PRIDE: isotoxische Dosiseskalation beim Glioblastom

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