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Image Fusion for Radiosurgery, Neurosurgery and Hypofractionated Radiotherapy.

Inoue HK, Nakajima A, Sato H, Noda SE, Saitoh J, Suzuki Y - Cureus (2015)

Bottom Line: All images are fused and registered on thin sliced CT sections and exactly demarcated targets are planned for treatment.Follow-up images are also able to register on this CT.Exact target changes, including volume, are possible in this fusion system.

View Article: PubMed Central - HTML - PubMed

Affiliation: Dept of Neurosurgery and Radiation Oncology, Institute of Neural Organization and Cyber Center, Kanto Neurosurgical Hospital.

ABSTRACT
Precise target detection is essential for radiosurgery, neurosurgery and hypofractionated radiotherapy because treatment results and complication rates are related to accuracy of the target definition. In skull base tumors and tumors around the optic pathways, exact anatomical evaluation of cranial nerves are important to avoid adverse effects on these structures close to lesions. Three-dimensional analyses of structures obtained with MR heavy T2-images and image fusion with CT thin-sliced sections are desirable to evaluate fine structures during radiosurgery and microsurgery. In vascular lesions, angiography is most important for evaluations of whole structures from feeder to drainer, shunt, blood flow and risk factors of bleeding. However, exact sites and surrounding structures in the brain are not shown on angiography. True image fusions of angiography, MR images and CT on axial planes are ideal for precise target definition. In malignant tumors, especially recurrent head and neck tumors, biologically active areas of recurrent tumors are main targets of radiosurgery. PET scan is useful for quantitative evaluation of recurrences. However, the examination is not always available at the time of radiosurgery. Image fusion of MR diffusion images with CT is always available during radiosurgery and useful for the detection of recurrent lesions. All images are fused and registered on thin sliced CT sections and exactly demarcated targets are planned for treatment. Follow-up images are also able to register on this CT. Exact target changes, including volume, are possible in this fusion system. The purpose of this review is to describe the usefulness of image fusion for 1) skull base, 2) vascular, 3) recurrent target detection, and 4) follow-up analyses in radiosurgery, neurosurgery and hypofractionated radiotherapy.

No MeSH data available.


Related in: MedlinePlus

A sellar tumor and the surrounding structures.A Gd-enhanced MR image (lower left) fused to thin-sliced CT (upper left). Image fusion of the heavy T2-image showing the dose plan sparing the oculomotor nerve (yellow arrows), optic nerve (green), and optic chiasm (pink).
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FIG5: A sellar tumor and the surrounding structures.A Gd-enhanced MR image (lower left) fused to thin-sliced CT (upper left). Image fusion of the heavy T2-image showing the dose plan sparing the oculomotor nerve (yellow arrows), optic nerve (green), and optic chiasm (pink).

Mentions: Many tumors, such as meningioma, pituitary adenoma, craniopharyngioma, optic glioma, and paranasal sinus carcinoma, originate in and around the optic pathways. Preservation of visual function is important for patients with these tumors. Precise target detection and optic pathway delineation are essential to avoid the adverse effects of radiosurgery/hypofractionated radiotherapy and surgical damage during microsurgery. Displacement, compression, and deformity of the optic pathway is shown on MR heavy T2-images and near bony structures on CT. During dose planning for radiosurgery, sparing the optic pathway (volume evaluation) and oculomotor nerve from treatment dose line is possible in cases using image fusion, as shown in Figure 5.


Image Fusion for Radiosurgery, Neurosurgery and Hypofractionated Radiotherapy.

Inoue HK, Nakajima A, Sato H, Noda SE, Saitoh J, Suzuki Y - Cureus (2015)

A sellar tumor and the surrounding structures.A Gd-enhanced MR image (lower left) fused to thin-sliced CT (upper left). Image fusion of the heavy T2-image showing the dose plan sparing the oculomotor nerve (yellow arrows), optic nerve (green), and optic chiasm (pink).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4494462&req=5

FIG5: A sellar tumor and the surrounding structures.A Gd-enhanced MR image (lower left) fused to thin-sliced CT (upper left). Image fusion of the heavy T2-image showing the dose plan sparing the oculomotor nerve (yellow arrows), optic nerve (green), and optic chiasm (pink).
Mentions: Many tumors, such as meningioma, pituitary adenoma, craniopharyngioma, optic glioma, and paranasal sinus carcinoma, originate in and around the optic pathways. Preservation of visual function is important for patients with these tumors. Precise target detection and optic pathway delineation are essential to avoid the adverse effects of radiosurgery/hypofractionated radiotherapy and surgical damage during microsurgery. Displacement, compression, and deformity of the optic pathway is shown on MR heavy T2-images and near bony structures on CT. During dose planning for radiosurgery, sparing the optic pathway (volume evaluation) and oculomotor nerve from treatment dose line is possible in cases using image fusion, as shown in Figure 5.

Bottom Line: All images are fused and registered on thin sliced CT sections and exactly demarcated targets are planned for treatment.Follow-up images are also able to register on this CT.Exact target changes, including volume, are possible in this fusion system.

View Article: PubMed Central - HTML - PubMed

Affiliation: Dept of Neurosurgery and Radiation Oncology, Institute of Neural Organization and Cyber Center, Kanto Neurosurgical Hospital.

ABSTRACT
Precise target detection is essential for radiosurgery, neurosurgery and hypofractionated radiotherapy because treatment results and complication rates are related to accuracy of the target definition. In skull base tumors and tumors around the optic pathways, exact anatomical evaluation of cranial nerves are important to avoid adverse effects on these structures close to lesions. Three-dimensional analyses of structures obtained with MR heavy T2-images and image fusion with CT thin-sliced sections are desirable to evaluate fine structures during radiosurgery and microsurgery. In vascular lesions, angiography is most important for evaluations of whole structures from feeder to drainer, shunt, blood flow and risk factors of bleeding. However, exact sites and surrounding structures in the brain are not shown on angiography. True image fusions of angiography, MR images and CT on axial planes are ideal for precise target definition. In malignant tumors, especially recurrent head and neck tumors, biologically active areas of recurrent tumors are main targets of radiosurgery. PET scan is useful for quantitative evaluation of recurrences. However, the examination is not always available at the time of radiosurgery. Image fusion of MR diffusion images with CT is always available during radiosurgery and useful for the detection of recurrent lesions. All images are fused and registered on thin sliced CT sections and exactly demarcated targets are planned for treatment. Follow-up images are also able to register on this CT. Exact target changes, including volume, are possible in this fusion system. The purpose of this review is to describe the usefulness of image fusion for 1) skull base, 2) vascular, 3) recurrent target detection, and 4) follow-up analyses in radiosurgery, neurosurgery and hypofractionated radiotherapy.

No MeSH data available.


Related in: MedlinePlus