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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 spinal arteriovenous malformation.Digital subtraction spinal angiography showing an intramedullary AVM in the cervical spinal cord (left). The 3-D reconstruction from the axial images of rotation angiography (middle line) showing the nidus and draining veins. The dose plan targeting the nidus while sparing the surrounding spinal cord, with the steepness of the isodose line on axial images of an angiogram (AG) fused to CT and enhanced MR images (right line).
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FIG10: A spinal arteriovenous malformation.Digital subtraction spinal angiography showing an intramedullary AVM in the cervical spinal cord (left). The 3-D reconstruction from the axial images of rotation angiography (middle line) showing the nidus and draining veins. The dose plan targeting the nidus while sparing the surrounding spinal cord, with the steepness of the isodose line on axial images of an angiogram (AG) fused to CT and enhanced MR images (right line).

Mentions: Spinal AVM is one of most difficult vascular diseases to treat in neurosurgery. Patients with spinal AVMs, especially intramedullary AVMs, have risks of tetraparesis or paraparesis due to hemorrhage or surgical procedures. Whole body (spinal) radiosurgery is an option to treat spinal AVMs with low treatment risks. Precise target detection is essential for radiosurgery, and true image fusion of spinal angiography is desirable for dose planning (Figure 10). Detailed nidus evaluation and sparing of the surrounding spinal cord are required to avoid adverse effects on functional spinal tracts.


Image Fusion for Radiosurgery, Neurosurgery and Hypofractionated Radiotherapy.

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

A spinal arteriovenous malformation.Digital subtraction spinal angiography showing an intramedullary AVM in the cervical spinal cord (left). The 3-D reconstruction from the axial images of rotation angiography (middle line) showing the nidus and draining veins. The dose plan targeting the nidus while sparing the surrounding spinal cord, with the steepness of the isodose line on axial images of an angiogram (AG) fused to CT and enhanced MR images (right line).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

FIG10: A spinal arteriovenous malformation.Digital subtraction spinal angiography showing an intramedullary AVM in the cervical spinal cord (left). The 3-D reconstruction from the axial images of rotation angiography (middle line) showing the nidus and draining veins. The dose plan targeting the nidus while sparing the surrounding spinal cord, with the steepness of the isodose line on axial images of an angiogram (AG) fused to CT and enhanced MR images (right line).
Mentions: Spinal AVM is one of most difficult vascular diseases to treat in neurosurgery. Patients with spinal AVMs, especially intramedullary AVMs, have risks of tetraparesis or paraparesis due to hemorrhage or surgical procedures. Whole body (spinal) radiosurgery is an option to treat spinal AVMs with low treatment risks. Precise target detection is essential for radiosurgery, and true image fusion of spinal angiography is desirable for dose planning (Figure 10). Detailed nidus evaluation and sparing of the surrounding spinal cord are required to avoid adverse effects on functional spinal tracts.

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