PURPOSE: To develop contouring guidelines for the brachial plexus (BP) using anatomically validated cadaver datasets. Magnetic resonance imaging (MRI) and computed tomography (CT) were used to obtain detailed visualizations of the BP region, with the goal of achieving maximal inclusion of the actual BP in a small contoured volume while also accommodating for anatomic variations. METHODS AND MATERIALS: CT and MRI were obtained for 8 cadavers positioned for intensity modulated radiation therapy. 3-dimensional reconstructions of soft tissue (from MRI) and bone (from CT) were combined to create 8 separate enhanced CT project files. Dissection of the corresponding cadavers anatomically validated the reconstructions created. Seven enhanced CT project files were then automatically fitted, separately in different regions, to obtain a single dataset of superimposed BP regions that incorporated anatomic variations. From this dataset, improved BP contouring guidelines were developed. These guidelines were then applied to the 7 original CT project files and also to 1 additional file, left out from the superimposing procedure. The percentage of BP inclusion was compared with the published guidelines. RESULTS: The anatomic validation procedure showed a high level of conformity for the BP regions examined between the 3-dimensional reconstructions generated and the dissected counterparts. Accurate and detailed BP contouring guidelines were developed, which provided corresponding guidance for each level in a clinical dataset. An average margin of 4.7 mm around the anatomically validated BP contour is sufficient to accommodate for anatomic variations. Using the new guidelines, 100% inclusion of the BP was achieved, compared with a mean inclusion of 37.75% when published guidelines were applied. CONCLUSION: Improved guidelines for BP delineation were developed using combined MRI and CT imaging with validation by anatomic dissection.
PURPOSE: To develop contouring guidelines for the brachial plexus (BP) using anatomically validated cadaver datasets. Magnetic resonance imaging (MRI) and computed tomography (CT) were used to obtain detailed visualizations of the BP region, with the goal of achieving maximal inclusion of the actual BP in a small contoured volume while also accommodating for anatomic variations. METHODS AND MATERIALS: CT and MRI were obtained for 8 cadavers positioned for intensity modulated radiation therapy. 3-dimensional reconstructions of soft tissue (from MRI) and bone (from CT) were combined to create 8 separate enhanced CT project files. Dissection of the corresponding cadavers anatomically validated the reconstructions created. Seven enhanced CT project files were then automatically fitted, separately in different regions, to obtain a single dataset of superimposed BP regions that incorporated anatomic variations. From this dataset, improved BP contouring guidelines were developed. These guidelines were then applied to the 7 original CT project files and also to 1 additional file, left out from the superimposing procedure. The percentage of BP inclusion was compared with the published guidelines. RESULTS: The anatomic validation procedure showed a high level of conformity for the BP regions examined between the 3-dimensional reconstructions generated and the dissected counterparts. Accurate and detailed BP contouring guidelines were developed, which provided corresponding guidance for each level in a clinical dataset. An average margin of 4.7 mm around the anatomically validated BP contour is sufficient to accommodate for anatomic variations. Using the new guidelines, 100% inclusion of the BP was achieved, compared with a mean inclusion of 37.75% when published guidelines were applied. CONCLUSION: Improved guidelines for BP delineation were developed using combined MRI and CT imaging with validation by anatomic dissection.
Authors: Joris Van de Velde; Stephanie Bogaert; Pieter Vandemaele; Wouter Huysse; Eric Achten; Joris Leijnse; Wilfried De Neve; Tom Van Hoof Journal: Surg Radiol Anat Date: 2015-08-23 Impact factor: 1.246
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Authors: Michael E J Stouthandel; Pim Pullens; Stephanie Bogaert; Max Schoepen; Carl Vangestel; Eric Achten; Liv Veldeman; Tom Van Hoof Journal: Strahlenther Onkol Date: 2022-04-11 Impact factor: 4.033
Authors: Tarita O Thomas; Tamer Refaat; Mehee Choi; Ian Bacchus; Sean Sachdev; Alfred W Rademaker; Vythialingam Sathiaseelan; Achilles Karagianis; Bharat B Mittal Journal: Radiat Oncol Date: 2015-04-18 Impact factor: 3.481
Authors: Joris Van de Velde; Johan Wouters; Tom Vercauteren; Werner De Gersem; Eric Achten; Wilfried De Neve; Tom Van Hoof Journal: Radiat Oncol Date: 2015-12-23 Impact factor: 3.481
Authors: Joris Van de Velde; Johan Wouters; Tom Vercauteren; Werner De Gersem; Eric Achten; Wilfried De Neve; Tom Van Hoof Journal: Radiat Oncol Date: 2016-01-07 Impact factor: 3.481