Delineation of Target Volume for Radiotherapy of High-Grade Gliomas by 99mTc-MIBI SPECT and MRI Fusion

Krengli, Marco; Loi, G.; Sacchetti, Gianmauro; Manfredda, I.; Gambaro, G.; Brambilla, Marco; Carriero, Alessandro; Inglese, Eugenio

doi:10.1007/s00066-007-1750-x

Cited by 16 publications

(14 citation statements)

References 24 publications

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“…Modern imaging technologies as well as improved understanding of tumor biology are more and more included into the process of radiotherapeutic target volume definition and subsequent treatment plan optimization [13,18]. In 2000, in a review, Ling et al [21] already summarized the idea of merging the target volume from different functional imaging techniques.…”

Section: Introductionmentioning

confidence: 99%

“…18 F-FET is a radiolabeled amino acid with a fast and specific accumulation in brain tumors. The specificity is caused by the increased expression of amino acid transporter on malignantly transformed cells.…”

Section: Introductionmentioning

confidence: 99%

“…The specificity is caused by the increased expression of amino acid transporter on malignantly transformed cells. Contrary to 18 F-fluorodeoxyglucose ( 18 F-FDG), the uptake in macrophages and inflammatory cells is much lower [5]. Although the kinetics of FET are not yet completely understood, an incorporation of FET into proteins can be excluded [19].…”

Section: Introductionmentioning

confidence: 99%

“…Although the kinetics of FET are not yet completely understood, an incorporation of FET into proteins can be excluded [19]. Weber et al [28] compared the uptake of 18 F-FET to the uptake of radiolabeled methionine evaluating the data of 16 patients and found a mean FET standard uptake value (SUV) of 2.7 ± 0.8 in tumor tissue (normal gray matter: 1.1 ± 0.2). Due to its tumor-specific characteristics, 18 F-FET-PET imaging is potentially predestinated to image-guided radiotherapeutic treatment planning with dose painting by numbers for brain tumors.…”

Section: Introductionmentioning

confidence: 99%

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A Biologically Adapted Dose-Escalation Approach, Demonstrated for 18F-FET-PET in Brain Tumors

et al. 2008

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Biologically Adapted Dose-Escalation Approach, Demonstrated for 18F-FET-PET in Brain Tumors

et al. 2008

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“…Krengli et al [6] studied the effect of Tcmethoxyisobutylisonitrile (MIBI)-SPECT fused with MR in target delineation. In 21 patients, they outlined GTV on SPECT and MR images and analysed three volumes: combined volumes on SPECT and MR, volume overlap between SPECT and MR and volume extension beyond MR.…”

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confidence: 99%

Clinical applications of imaging biomarkers. Part 3. The neuro-oncologist's perspective

Shenoy

2011

BJR

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ABSTRACT. Radiation therapy is an important treatment modality in the management of brain tumours. Imaging biomarkers continue to be a focus of active investigation and there is increasing evidence of the utility of biomarkers in refining the overall management plan. This article briefly reviews the literature and outlines the possible clinical applications of imaging biomarkers in neuro-oncology. Advanced imaging in radiotherapy planningRadiation therapy continues to play an important role in the treatment of brain tumours. As an initial step in radiotherapy planning, patients undergo a contrastenhanced CT scan in the treatment position. This serves two purposes: (1) delineation of target volumes and organs at risk and (2) electron density information is used for dosimetry. MRI has been used to improve the accuracy of outlining tumours owing to the superiority of magnetic resonance (MR) in identifying intracranial anatomical structures.Thornton et al [1] presented their clinical experience gained since the introduction of MR fusion to CT planning. They noted fusion of MR images to CT planning images allowed for display of MR-defined organs onto CT images, treatment planning could be carried out on composite images and doses could be displayed onto either set of images. They found that target outlining had to be changed because of the delineation of structures on MR images that were not visible on CT images. They reported that MR increased the clinical target volume (CTV) compared with that seen on CT and felt that the integration of MR data with CT information was of significant practical value in treatment planning. Datta et al [2] prospectively outlined the CTV and gross tumour volume (GTV) separately on CT and MR images in 21 patients. The volumes were estimated and their congruence studied. They noted that, compared with MR, CT underestimated the volumes with significant differences in the mean CTV and GTV. They concluded that target delineation for brain tumours should be based on MRI to reduce geographic misses.Aoyama et al [3] developed an MRI system for radiotherapy planning, and GTVs were independently outlined on MR-CT and CT in 41 patients by 4 clinicians. The differences between observers and imaging modalities were analysed. They reported that MR fusion reduced target volumes and significantly reduced interobserver variability. Weltens et al [4] assessed the interobserver variation on CT planning and the additional impact of MR information. 9 clinicians outlined GTV in 5 patients on CT images and on MR images 2 weeks later. It was noted that there was a high interobserver variability in GTV delineation on CT, which was not reduced by the addition of MR data. However, they recommended a combination of the two modalities for treatment planning.In a study of 30 patients comparing 123I-alpha-methyltyrosine single photon emission computed tomography (IMT-SPECT) with MRI, Grosu et al [5] showed that additional information from IMT-SPECT led to an increase in the target volumes by an average of 20% and s...

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Radiation Therapy Planning Using SPECT-CT

2011

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Delineation of Target Volume for Radiotherapy of High-Grade Gliomas by 99mTc-MIBI SPECT and MRI Fusion

Abstract: The fusion of 99m Tc-MIBI SPECT and MRI significantly affected the delineation of the target volume identified by MRI alone.

Cited by 16 publications

References 24 publications

A Biologically Adapted Dose-Escalation Approach, Demonstrated for 18F-FET-PET in Brain Tumors

A Biologically Adapted Dose-Escalation Approach, Demonstrated for 18F-FET-PET in Brain Tumors

Clinical applications of imaging biomarkers. Part 3. The neuro-oncologist's perspective

Radiation Therapy Planning Using SPECT-CT

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