1. On PTV definition for glioblastoma based on fiber tracking of diffusion tensor imaging data.
- Author
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Witulla B, Goerig N, Putz F, Frey B, Engelhorn T, Dörfler A, Uder M, Fietkau R, Bert C, and Laun FB
- Subjects
- Algorithms, Brain Neoplasms pathology, Brain Neoplasms surgery, Follow-Up Studies, Glioblastoma pathology, Glioblastoma surgery, Humans, Magnetic Resonance Imaging, Neoplasm Recurrence, Local prevention & control, Prognosis, Brain Neoplasms diagnostic imaging, Brain Neoplasms radiotherapy, Diffusion Tensor Imaging methods, Glioblastoma diagnostic imaging, Glioblastoma radiotherapy, Radiotherapy Planning, Computer-Assisted methods, Tumor Burden
- Abstract
Radiotherapy (RT) is commonly applied for the treatment of glioblastoma multiforme (GBM). Following the planning target volume (PTV) definition procedure standardized in guidelines, a 20% risk of missing non-local recurrences is present. Purpose of this study was to evaluate whether diffusion tensor imaging (DTI)-based fiber tracking may be beneficial for PTV definition taking into account the prediction of distant recurrences. 56 GBM patients were examined with magnetic resonance imaging (MRI) including DTI performed before RT after resection of the primary tumor. Follow-up MRIs were acquired in three month intervals. For the seven patients with a distant recurrence, fiber tracking was performed with three algorithms and it was evaluated whether connections existed from the primary tumor region to the distant recurrence. It depended strongly on the used tracking algorithm and the used tracking parameters whether a connection was observed. Most of the connections were weak and thus not usable for PTV definition. Only in one of the seven patients with a recurring tumor, a clear connection was present. It seems unlikely that DTI-based fiber tracking can be beneficial for predicting distant recurrences in the planning of PTVs for glioblastoma multiforme., Competing Interests: The authors have declared that no competing interests exist.
- Published
- 2020
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