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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

Trigeminal neuralgia.Heavy T2-images (fused to thin-sliced CT) of the trigeminal nerve showing the three branches of the pre-ganglion portion, the Gasserian ganglion, and the retro-ganglion portion. The retro-ganglion portion at the petrous apex is targeted, and the abducens nerve (green) is out of prescribed isodose range.
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FIG6: Trigeminal neuralgia.Heavy T2-images (fused to thin-sliced CT) of the trigeminal nerve showing the three branches of the pre-ganglion portion, the Gasserian ganglion, and the retro-ganglion portion. The retro-ganglion portion at the petrous apex is targeted, and the abducens nerve (green) is out of prescribed isodose range.

Mentions: Idiopathic trigeminal neuralgia is caused by chronic vascular compression of the trigeminal nerve and disappears immediately after decompression of the offending artery with microsurgery. Changes in the trigeminal nerve, such as deformity, angulations, and displacement, are clearly shown in the merge view of MRI and MRA. The merge view is useful for surgical approaches used during microvascular decompression. The 3-D image of the trigeminal nerve is also required for radiosurgery [10]. In dose planning for radiosurgery using image fusion of heavy T2-MR images to thin-sliced CT, the target point is clearly shown and the abducens nerve is out of the prescribed isodose line, as shown in Figure 6.


Image Fusion for Radiosurgery, Neurosurgery and Hypofractionated Radiotherapy.

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

Trigeminal neuralgia.Heavy T2-images (fused to thin-sliced CT) of the trigeminal nerve showing the three branches of the pre-ganglion portion, the Gasserian ganglion, and the retro-ganglion portion. The retro-ganglion portion at the petrous apex is targeted, and the abducens nerve (green) is out of prescribed isodose range.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

FIG6: Trigeminal neuralgia.Heavy T2-images (fused to thin-sliced CT) of the trigeminal nerve showing the three branches of the pre-ganglion portion, the Gasserian ganglion, and the retro-ganglion portion. The retro-ganglion portion at the petrous apex is targeted, and the abducens nerve (green) is out of prescribed isodose range.
Mentions: Idiopathic trigeminal neuralgia is caused by chronic vascular compression of the trigeminal nerve and disappears immediately after decompression of the offending artery with microsurgery. Changes in the trigeminal nerve, such as deformity, angulations, and displacement, are clearly shown in the merge view of MRI and MRA. The merge view is useful for surgical approaches used during microvascular decompression. The 3-D image of the trigeminal nerve is also required for radiosurgery [10]. In dose planning for radiosurgery using image fusion of heavy T2-MR images to thin-sliced CT, the target point is clearly shown and the abducens nerve is out of the prescribed isodose line, as shown in Figure 6.

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