Radiation sparing of cerebral cortex in brain tumor patients using quantitative neuroimaging

Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology
Roshan A KarunamuniJona A Hattangadi-Gluth

Abstract

Neurocognitive decline in brain tumor patients treated with radiotherapy (RT) may be linked to cortical atrophy. We developed models to determine radiation treatment-planning objectives for cortex, which were tested on a sample population to identify the dosimetric cost of cortical sparing. The relationship between the probability of cortical atrophy in fifteen high-grade glioma patients at 1-year post-RT and radiation dose was fit using logistic mixed effects modeling. Cortical sparing was implemented using two strategies: region-specific sparing using model parameters, and non-specific sparing of all normal brain tissue. A dose threshold of 28.6 Gy was found to result in a 20% probability of severe atrophy. Average cortical sparing at 30 Gy was greater for region-specific dose avoidance (4.6%) compared to non-specific (3.6%). Cortical sparing resulted in an increase in heterogeneity index of the planning target volume (PTV) with an average increase of 1.9% (region-specific) and 0.9% (non-specific). We found RT doses above 28.6 Gy resulted in a greater than 20% probability of cortical atrophy. Cortical sparing can be achieved using region-specific or non-specific dose avoidance strategies at the cost of an increase in the dose...Continue Reading

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Citations

Feb 24, 2016·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Annika LattermannMechthild Krause
Dec 17, 2016·Nature Reviews. Neurology·Milan T MakaleSantosh Kesari
Feb 8, 2018·Radiation Oncology·Ann-Katrin ExeliHeinz Deutschmann
Oct 6, 2017·Physics in Medicine and Biology·Jonathan H MasonMike E Davies
Jul 10, 2018·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Flavie BompaireDamien Ricard
Dec 10, 2020·Journal of medical and biological engineering·Patricia ClementEsther A H Warnert
Apr 4, 2021·Cancers·Katharina WitzmannEsther G C Troost
Oct 26, 2016·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Michael ConnorJona Hattangadi-Gluth
Mar 10, 2018·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Vyacheslav L MurzinJona A Hattangadi-Gluth

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