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- Title
Applying a Radiation Therapy Volume Analysis Pipeline to Determine the Utility of Spectroscopic MRI-Guided Adaptive Radiation Therapy for Glioblastoma.
- Authors
Trivedi, Anuradha G.; Kim, Su Hyun; Ramesh, Karthik K.; Giuffrida, Alexander S.; Weinberg, Brent D.; Mellon, Eric A.; Kleinberg, Lawrence R.; Barker, Peter B.; Han, Hui; Shu, Hui-Kuo G.; Shim, Hyunsuk; Schreibmann, Eduard
- Abstract
Accurate radiation therapy (RT) targeting is crucial for glioblastoma treatment but may be challenging using clinical imaging alone due to the infiltrative nature of glioblastomas. Precise targeting by whole-brain spectroscopic MRI, which maps tumor metabolites including choline (Cho) and N-acetylaspartate (NAA), can quantify early treatment-induced molecular changes that other traditional modalities cannot measure. We developed a pipeline to determine how spectroscopic MRI changes during early RT are associated with patient outcomes to provide insight into the utility of adaptive RT planning. Data were obtained from a study (NCT03137888) where glioblastoma patients received high-dose RT guided by the pre-RT Cho/NAA twice normal (Cho/NAA ≥ 2x) volume, and received spectroscopic MRI scans pre- and mid-RT. Overlap statistics between pre- and mid-RT scans were used to quantify metabolic activity changes after two weeks of RT. Log-rank tests were used to quantify the relationship between imaging metrics and patient overall and progression-free survival (OS/PFS). Patients with lower Jaccard/Dice coefficients had longer PFS (p = 0.045 for both), and patients with lower Jaccard/Dice coefficients had higher OS trending towards significance (p = 0.060 for both). Cho/NAA ≥ 2x volumes changed significantly during early RT, putting healthy tissue at risk of irradiation, and warranting further study into using adaptive RT planning.
- Subjects
RADIOTHERAPY; GLIOBLASTOMA multiforme; LOG-rank test; PROGRESSION-free survival; DIAGNOSTIC imaging; MAGNETOENCEPHALOGRAPHY
- Publication
Tomography: A Journal for Imaging Research, 2023, Vol 9, Issue 3, p1052
- ISSN
2379-1381
- Publication type
Article
- DOI
10.3390/tomography9030086