OBJECTIVES: Delineation of clinical target volume (CTV) is still controversial in glioblastomas. In order to assess the differences in volume and shape of the radiotherapy target, the use of pre-operative vs post-operative/pre-radiotherapy T(1) and T(2) weighted MRI was compared. METHODS: 4 CTVs were delineated in 24 patients pre-operatively and post-operatively using T(1) contrast-enhanced (T1(PRE)CTV and T1(POST)CTV) and T(2) weighted images (T2(PRE)CTV and T2(POST)CTV). Pre-operative MRI examinations were performed the day before surgery, whereas post-operative examinations were acquired 1 month after surgery and before chemoradiation. A concordance index (CI) was defined as the ratio between the overlapping and composite volumes. RESULTS: The volumes of T1(PRE)CTV and T1(POST)CTV were not statistically different (248 ± 88 vs 254 ± 101), although volume differences >100 cm(3) were observed in 6 out of 24 patients. A marked increase due to tumour progression was shown in three patients. Three patients showed a decrease because of a reduced mass effect. A significant reduction occurred between pre-operative and post-operative T(2) volumes (139 ± 68 vs 78 ± 59). Lack of concordance was observed between T1(PRE)CTV and T1(POST)CTV (CI = 0.67 ± 0.09), T2(PRE)CTV and T2(POST)CTV (CI = 0.39 ± 0.20) and comparing the portion of the T1(PRE)CTV and T1(POST)CTV not covered by that defined on T2(PRE)CTV images (CI = 0.45 ± 0.16 and 0.44 ± 0.17, respectively). CONCLUSION: Using T(2) MRI, huge variations can be observed in peritumoural oedema, which are probably due to steroid treatment. Using T(1) MRI, brain shifts after surgery and possible progressive enhancing lesions produce substantial differences in CTVs. Our data support the use of post-operative/pre-radiotherapy T(1) weighted MRI for planning purposes.
OBJECTIVES: Delineation of clinical target volume (CTV) is still controversial in glioblastomas. In order to assess the differences in volume and shape of the radiotherapy target, the use of pre-operative vs post-operative/pre-radiotherapy T(1) and T(2) weighted MRI was compared. METHODS: 4 CTVs were delineated in 24 patients pre-operatively and post-operatively using T(1) contrast-enhanced (T1(PRE)CTV and T1(POST)CTV) and T(2) weighted images (T2(PRE)CTV and T2(POST)CTV). Pre-operative MRI examinations were performed the day before surgery, whereas post-operative examinations were acquired 1 month after surgery and before chemoradiation. A concordance index (CI) was defined as the ratio between the overlapping and composite volumes. RESULTS: The volumes of T1(PRE)CTV and T1(POST)CTV were not statistically different (248 ± 88 vs 254 ± 101), although volume differences >100 cm(3) were observed in 6 out of 24 patients. A marked increase due to tumour progression was shown in three patients. Three patients showed a decrease because of a reduced mass effect. A significant reduction occurred between pre-operative and post-operative T(2) volumes (139 ± 68 vs 78 ± 59). Lack of concordance was observed between T1(PRE)CTV and T1(POST)CTV (CI = 0.67 ± 0.09), T2(PRE)CTV and T2(POST)CTV (CI = 0.39 ± 0.20) and comparing the portion of the T1(PRE)CTV and T1(POST)CTV not covered by that defined on T2(PRE)CTV images (CI = 0.45 ± 0.16 and 0.44 ± 0.17, respectively). CONCLUSION: Using T(2) MRI, huge variations can be observed in peritumoural oedema, which are probably due to steroid treatment. Using T(1) MRI, brain shifts after surgery and possible progressive enhancing lesions produce substantial differences in CTVs. Our data support the use of post-operative/pre-radiotherapy T(1) weighted MRI for planning purposes.
Authors: Eric L Chang; Serap Akyurek; Tedde Avalos; Neal Rebueno; Chris Spicer; John Garcia; Robin Famiglietti; Pamela K Allen; K S Clifford Chao; Anita Mahajan; Shiao Y Woo; Moshe H Maor Journal: Int J Radiat Oncol Biol Phys Date: 2007-02-15 Impact factor: 7.038
Authors: Ingeborg Bosma; Maaike J Vos; Jan J Heimans; Martin J B Taphoorn; Neil K Aaronson; Tjeerd J Postma; Henk M van der Ploeg; Martin Muller; W Peter Vandertop; Ben J Slotman; Martin Klein Journal: Neuro Oncol Date: 2006-10-03 Impact factor: 12.300
Authors: Lutz W Kracht; Hrvoje Miletic; Susanne Busch; Andreas H Jacobs; Jurgen Voges; Moritz Hoevels; Johannes C Klein; Karl Herholz; Wolf-D Heiss Journal: Clin Cancer Res Date: 2004-11-01 Impact factor: 12.531
Authors: Christina Tsien; Diana Gomez-Hassan; Randall K Ten Haken; Daniel Tatro; L Junck; T L Chenevert; T Lawrence Journal: Int J Radiat Oncol Biol Phys Date: 2005-06-01 Impact factor: 7.038
Authors: June L Chan; Susan W Lee; Benedick A Fraass; Daniel P Normolle; Harry S Greenberg; Larry R Junck; Stephen S Gebarski; Howard M Sandler Journal: J Clin Oncol Date: 2002-03-15 Impact factor: 44.544
Authors: Andreas Stadlbauer; Ewald Moser; Stephan Gruber; Rolf Buslei; Christopher Nimsky; Rudolf Fahlbusch; Oliver Ganslandt Journal: Neuroimage Date: 2004-10 Impact factor: 6.556
Authors: Brigitta G Baumert; Michael Brada; Jacques Bernier; Rolf D Kortmann; Cary Dehing-Oberije; Laurence Collette; J Bernard Davis Journal: Radiother Oncol Date: 2008-04-30 Impact factor: 6.280
Authors: Y M Archibald; D Lunn; L A Ruttan; D R Macdonald; R F Del Maestro; H W Barr; J H Pexman; B J Fisher; L E Gaspar; J G Cairncross Journal: J Neurosurg Date: 1994-02 Impact factor: 5.115
Authors: L Danieli; G C Riccitelli; D Distefano; E Prodi; E Ventura; A Cianfoni; A Kaelin-Lang; M Reinert; E Pravatà Journal: AJNR Am J Neuroradiol Date: 2019-06-20 Impact factor: 3.825
Authors: Michael Christensen; David Olayinka Kamson; Michael Snyder; Harold Kim; Natasha L Robinette; Sandeep Mittal; Csaba Juhász Journal: J Radiat Oncol Date: 2014-06
Authors: Eric D Morris; Ryan G Price; Joshua Kim; Lonni Schultz; M Salim Siddiqui; Indrin Chetty; Carri Glide-Hurst Journal: Pract Radiat Oncol Date: 2018-04-06
Authors: Marc D Piroth; Norbert Galldiks; Michael Pinkawa; Richard Holy; Gabriele Stoffels; Johannes Ermert; Felix M Mottaghy; N Jon Shah; Karl-Josef Langen; Michael J Eble Journal: Radiat Oncol Date: 2016-06-24 Impact factor: 3.481