Assessment of Computed Tomography (CT) And Magnetic Resonance Imaging (MRI) Based Radiosurgery Treatment Planning for Pituitary Adenomas

Abstract

Aim: Pituitary adenomas are fairly common benign tumors which may be found in up to 20% of the general population. While a considerable proportion of patients harboring these benign tumors may be asymptomatic, symptoms may arise due to the mass effect on critical neurovascular structures including the optic nerves and chiasm, cavernous sinus, and normally functioning pituitary gland or stalk. Radiosurgery may be used as a viable therapeutic option for management of pituitary adenomas. Treatment planing for radiosurgery is typically performed by Computed Tomography (CT)-simulation, however, multimodality imaging may add to the accuracy of target contouring for pituitary adenomas. In this study, we evaluated the utility of multimodality imaging with CT and Magnetic Resonance Imaging (MRI) for radiosurgery treatment planning of pituitary adenomas. Methods and Materials:The study group included 18 patients who received radiosurgery for pituitary adenoma at our department. A comparative assessment was performed to investigate the incorporation of MRI into radiosurgery treatment planning for pituitary adenomas.Results: A total of 18 patients receiving radiosurgery for pituitary adenomas at our department were assessed for target volume definition by use of CT-only imaging and CT-MR fusion based imaging in this study. Mean target volume was 4.4 cc (range: 1.1-10.9 cc) on CT-only imaging, 4.7 cc (range: 1.2-11.1 cc) on CT-MR fusion based imaging, and 4.6 cc (range: 1.2-11.2 cc) on collaboration and consensus of treating radiation oncologists by using all available imaging data of the patients. Conclusion:Ground truth target volume was identical to target determination based on CT-MR fusion based imaging in majority of our study group. MRI offers a viable imaging modality for pituitary adenoma target definition and may substantially improve accuracy and precision in target contouring for radiosurgery of pituitary adenomas.

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)

“…Axial MRI of intracranial GCT is demonstrated on Figure 2. [32][33][34][35][36][37][38][39]. In the context of intracranial GCT management, irradiation with less extensive treatment portals and lower doses has been investigated for improved normal tissue sparing and quality of life.…”

“…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].…”