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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 dural arteriovenous fistula (AVF).Digital subtraction angiography showing a dural AVF of the superior sagittal sinus (left). The 3-D reconstruction from axial images of rotation angiography (middle line) showing fistulas to the sinus. The fistula points are clearly shown in 3-D images (crossed line). The dose plan targeting the AVF and the sinus wall on axial images of an angiogram (AG) fused to those of CT angiogram (CTA) and enhanced MR angiogram (MRA).
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FIG11: A dural arteriovenous fistula (AVF).Digital subtraction angiography showing a dural AVF of the superior sagittal sinus (left). The 3-D reconstruction from axial images of rotation angiography (middle line) showing fistulas to the sinus. The fistula points are clearly shown in 3-D images (crossed line). The dose plan targeting the AVF and the sinus wall on axial images of an angiogram (AG) fused to those of CT angiogram (CTA) and enhanced MR angiogram (MRA).

Mentions: Dural AVFs are usually indications for intervention, and transvenous approaches are most frequently used. The 3-D reconstruction images from rotation angiography are useful for intervention and direct surgery. When patients have recurrent lesions after intervention, risks of thrombosis of a major venous sinus, or have medical contraindications for surgical procedures, radiosurgery is a less invasive and safer treatment for dural AVFs. Total obliteration preserving major venous sinuses is obtained more safely and earlier than brain AVM obliteration after radiosurgery [15-16]. True image fusion of angiography via CT and MR images is useful to detect fistula points and to determine the targets for radiosurgery, as shown in Figure 11.


Image Fusion for Radiosurgery, Neurosurgery and Hypofractionated Radiotherapy.

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

A dural arteriovenous fistula (AVF).Digital subtraction angiography showing a dural AVF of the superior sagittal sinus (left). The 3-D reconstruction from axial images of rotation angiography (middle line) showing fistulas to the sinus. The fistula points are clearly shown in 3-D images (crossed line). The dose plan targeting the AVF and the sinus wall on axial images of an angiogram (AG) fused to those of CT angiogram (CTA) and enhanced MR angiogram (MRA).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

FIG11: A dural arteriovenous fistula (AVF).Digital subtraction angiography showing a dural AVF of the superior sagittal sinus (left). The 3-D reconstruction from axial images of rotation angiography (middle line) showing fistulas to the sinus. The fistula points are clearly shown in 3-D images (crossed line). The dose plan targeting the AVF and the sinus wall on axial images of an angiogram (AG) fused to those of CT angiogram (CTA) and enhanced MR angiogram (MRA).
Mentions: Dural AVFs are usually indications for intervention, and transvenous approaches are most frequently used. The 3-D reconstruction images from rotation angiography are useful for intervention and direct surgery. When patients have recurrent lesions after intervention, risks of thrombosis of a major venous sinus, or have medical contraindications for surgical procedures, radiosurgery is a less invasive and safer treatment for dural AVFs. Total obliteration preserving major venous sinuses is obtained more safely and earlier than brain AVM obliteration after radiosurgery [15-16]. True image fusion of angiography via CT and MR images is useful to detect fistula points and to determine the targets for radiosurgery, as shown in Figure 11.

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