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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 cerebello-pontine angle tumor and the surrounding structures.A Gd-enhanced MR image (lower left) fused to thin-sliced CT (upper left). The image fusion of a heavy T2-image showing the dose plan sparing the 7th and 8th nerves (green), cochlea (blue), 6th nerve (small yellow arrow), and 5th nerve (large yellow arrow).
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FIG7: A cerebello-pontine angle tumor and the surrounding structures.A Gd-enhanced MR image (lower left) fused to thin-sliced CT (upper left). The image fusion of a heavy T2-image showing the dose plan sparing the 7th and 8th nerves (green), cochlea (blue), 6th nerve (small yellow arrow), and 5th nerve (large yellow arrow).

Mentions: In the era of radiosurgery, hearing preservation is an important goal of treatment for acoustic tumors [11]. The 3-D heavy T2-imaging can clearly show the superior and inferior vestibular nerves, facial nerve, cochlear nerve, cochlea, and semicircular canals (see Figure 4). The facial nerve around small acoustic tumors is also usually shown on the ventral side of tumors. The extent of the intracanalicular part of the tumor is then shown by MR and CT image fusion. In dose planning for radiosurgery/hypofractionated radiotherapy, the isodose on these neural structures should be limited for functional preservation (Figure 7).


Image Fusion for Radiosurgery, Neurosurgery and Hypofractionated Radiotherapy.

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

A cerebello-pontine angle tumor and the surrounding structures.A Gd-enhanced MR image (lower left) fused to thin-sliced CT (upper left). The image fusion of a heavy T2-image showing the dose plan sparing the 7th and 8th nerves (green), cochlea (blue), 6th nerve (small yellow arrow), and 5th nerve (large yellow arrow).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

FIG7: A cerebello-pontine angle tumor and the surrounding structures.A Gd-enhanced MR image (lower left) fused to thin-sliced CT (upper left). The image fusion of a heavy T2-image showing the dose plan sparing the 7th and 8th nerves (green), cochlea (blue), 6th nerve (small yellow arrow), and 5th nerve (large yellow arrow).
Mentions: In the era of radiosurgery, hearing preservation is an important goal of treatment for acoustic tumors [11]. The 3-D heavy T2-imaging can clearly show the superior and inferior vestibular nerves, facial nerve, cochlear nerve, cochlea, and semicircular canals (see Figure 4). The facial nerve around small acoustic tumors is also usually shown on the ventral side of tumors. The extent of the intracanalicular part of the tumor is then shown by MR and CT image fusion. In dose planning for radiosurgery/hypofractionated radiotherapy, the isodose on these neural structures should be limited for functional preservation (Figure 7).

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