PMID- 35707751
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220716
IS  - 2513-9878 (Electronic)
IS  - 2513-9878 (Linking)
VI  - 3
IP  - 1
DP  - 2021
TI  - Volumetric and dosimetric impact of post-surgical MRI-guided radiotherapy for 
      glioblastoma: A pilot study.
PG  - 20210067
LID - 10.1259/bjro.20210067 [doi]
LID - 20210067
AB  - OBJECTIVES: Glioblastoma (GBM) radiotherapy (RT) target delineation requires MRI, 
      ideally concurrent with CT simulation (pre-RT MRI). Due to limited MRI 
      availability, <72 h post-surgery MRI is commonly used instead. Whilst previous 
      investigations assessed volumetric differences between post-surgical and pre-RT 
      delineations, dosimetric impact remains unknown. We quantify volumetric and 
      dosimetric impact of using post-surgical MRI for GBM target delineation. METHODS: 
      Gross tumour volumes (GTVs) for five GBM patients receiving chemo-RT with 
      post-surgical and pre-RT MRIs were delineated by three independent observers. 
      Planning target volumes (PTVs) and RT plans were generated for each GTV. 
      Volumetric and dosimetric differences were assessed through: absolute volumes, 
      volume-distance histograms and dose-volume histogram statistics. RESULTS: 
      Post-surgical MRI delineations had significantly (p < 0.05) larger GTV and PTV 
      volumes (median 16.7 and 64.4 cm(3,) respectively). Post-surgical RT plans, 
      applied to pre-RT delineations, had significantly decreased (p < 0.01) median PTV 
      doses (DeltaD99% = -8.1 Gy and DeltaD95% = -2.0 Gy). Median organ-at-risk (OAR) dose 
      increases (brainstem DeltaD5% =+0.8, normal brain mean dose =+2.9 and normal brain 
      DeltaD10% = 5.3 Gy) were observed. CONCLUSION: Post-surgical MRI delineation 
      significantly impacted RT planning, with larger normal-appearing tissue volumes 
      irradiated and increased OAR doses, despite a reduced coverage of the pre-RT 
      defined target. ADVANCES IN KNOWLEDGE: We believe this is the first investigation 
      assessing the dosimetric impact of using post-surgical MRI for GBM target 
      delineation. It highlights the potential of significantly degraded RT plans, 
      showing the clinical need for dedicated MRI for GBM RT.
CI  - (c) 2021 The Authors. Published by the British Institute of Radiology.
FAU - Tyyger, Marcus
AU  - Tyyger M
AUID- ORCID: 0000-0001-8491-1298
AD  - Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
FAU - Bhaumik, Suchandana
AU  - Bhaumik S
AD  - Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
FAU - Nix, Michael
AU  - Nix M
AD  - Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
FAU - Currie, Stuart
AU  - Currie S
AD  - Department of Neuroradiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
FAU - Nallathambi, Chandran
AU  - Nallathambi C
AD  - Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
FAU - Speight, Richard
AU  - Speight R
AD  - Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
FAU - Al-Qaisieh, Bashar
AU  - Al-Qaisieh B
AD  - Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
FAU - Murray, Louise
AU  - Murray L
LA  - eng
PT  - Journal Article
DEP - 20211126
PL  - England
TA  - BJR Open
JT  - BJR open
JID - 101749810
PMC - PMC9185844
EDAT- 2022/06/17 06:00
MHDA- 2022/06/17 06:01
PMCR- 2021/11/26
CRDT- 2022/06/16 02:45
PHST- 2021/10/26 00:00 [received]
PHST- 2021/11/08 00:00 [accepted]
PHST- 2022/06/16 02:45 [entrez]
PHST- 2022/06/17 06:00 [pubmed]
PHST- 2022/06/17 06:01 [medline]
PHST- 2021/11/26 00:00 [pmc-release]
AID - 10.1259/bjro.20210067 [doi]
PST - epublish
SO  - BJR Open. 2021 Nov 26;3(1):20210067. doi: 10.1259/bjro.20210067. eCollection 
      2021.