Evaluation of variability in target volume delineation for newly diagnosed glioblastoma: a multi-institutional study from the Korean Radiation Oncology Group

Wee, Chan Woo; Sung, Wonmo; Kang, Hyeyoung; Cho, Kwan Ho; Han, Tae‐Hee; Jeong, Bae Kwon; Jeong, Jae Uk; Kim, Haeyoung; Kim, In Ah; Kim, Jin Hee; Kim, Sung Hwan; Kim, Suzy; Lee, Dong Hoon; Lee, Me Yeon; Lim, Do Hoon; Park, Hye Li; Suh, Chang Ok; Yoon, Sang Min; Kim, Il Han

doi:10.1186/s13014-015-0439-z

“…Radiotherapy planning includes registration (aka "fusion") of the post-operative MRI (T1CE and FLAIR sequences) with the planning simulation CT, which allows for delineation of the FLAIR abnormality and residual enhancement in treatment planning. Guidelines for these delineations exist, but substantial variation is observed among practitioners from different cooperative groups (e.g., RTOG 22 vs. EORTC 23 ), and even among practitioners from one country, 24 but all utilize post-operative Figure 11.…”

Section: Mr Imaging To Define the At Risk Target Volumes And Organs Amentioning

confidence: 99%

Advanced Magnetic Resonance Imaging in Glioblastoma: A Review

Shukla¹,

Alexander²,

Bakas³

et al. 2018

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“…Radiotherapy planning includes registration (aka "fusion") of the post-operative MRI (T1CE and FLAIR sequences) with the planning simulation CT, which allows for delineation of the FLAIR abnormality and residual enhancement in treatment planning. Guidelines for these delineations exist, but substantial variation is observed among practitioners from different cooperative groups (e.g., RTOG 22 vs. EORTC 23 ), and even among practitioners from one country, 24 but all utilize post-operative Dynamic susceptibility contrast (DSC) perfusion weighted image. There is increase in rCBV (relative cerebral blood volume) in the region of right frontal mass (Figures 1-4), a finding favoring high grade neoplasm.…”

Section: Response Assessmentmentioning

confidence: 99%

Advanced magnetic resonance imaging in glioblastoma: a review

Shukla¹,

Alexander²,

Bakas³

et al. 2017

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Glioblastoma, the most common and most rapidly progressing primary malignant tumor of the central nervous system, continues to portend a dismal prognosis, despite improvements in diagnostic and therapeutic strategies over the last 20 years. The standard of care radiographic characterization of glioblastoma is magnetic resonance imaging (MRI), which is a widely utilized examination in the diagnosis and post-treatment management of patients with glioblastoma. Basic MRI modalities available from any clinical scanner, including native T1-weighted (T1w) and contrast-enhanced (T1CE), T2-weighted (T2w), and T2-fluid-attenuated inversion recovery (T2-FLAIR) sequences, provide critical clinical information about various processes in the tumor environment. In the last decade, advanced MRI modalities are increasingly utilized to further characterize glioblastomas more comprehensively. These include multi-parametric MRI sequences, such as dynamic susceptibility contrast (DSC), dynamic contrast enhancement (DCE), higher order diffusion techniques such as diffusion tensor imaging (DTI), and MR spectroscopy (MRS). Significant efforts are ongoing to implement these advanced imaging modalities into improved clinical workflows and personalized therapy approaches. Functional MRI (fMRI) and tractography are increasingly being used to identify eloquent cortices and important tracts to minimize postsurgical neuro-deficits. A contemporary review of the application of standard and advanced MRI in clinical neuro-oncologic practice is presented here.

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“…However, radiotherapy treatment planning relies on tumor manual segmentation by physicians, making the process tedious, time-consuming, and sensitive to bias due to low inter-observer agreement (Wee et al, 2015).…”

Section: Introductionmentioning

confidence: 99%