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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 recurrent neck cancer.MR diffusion images merged to thin-sliced CT axial sections showing a recurrent lesion in the neck, in the same locations as indicated by the PET scan (left line). The Gd-enhanced MR image is fused to CT and used for dose planning (center). The target of hypofractionated radiotherapy is demarcated based on the merged images.
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FIG12: A recurrent neck cancer.MR diffusion images merged to thin-sliced CT axial sections showing a recurrent lesion in the neck, in the same locations as indicated by the PET scan (left line). The Gd-enhanced MR image is fused to CT and used for dose planning (center). The target of hypofractionated radiotherapy is demarcated based on the merged images.

Mentions: PET scanning is usually used to detect recurrences and metastases in follow-up studies of patients with cancers. MR diffusion imaging is also helpful to detect recurrent lesions during radiosurgery, especially recurrent head and neck tumors, as shown in Figure 12. However, the exact site of positive areas is not clearly shown. Image fusion with CT and MR diffusion images will enable the delineation of the target for radiosurgery, as well as PET scanning [17-18]. Direct image fusion of MR diffusion images to thin-sliced CT for radiosurgery is not precise yet. At present, merged images of MR and CT are made, and the target is delineated on the merged images (Figure 12). Then, image fusion of Gd-enhanced MR images to CT is performed for dose planning prior to radiosurgery. The image fusion supported with merged images is useful, especially for patients who received reconstructive surgery after removal of head and neck tumors, because the normal structures are often not shown, and recurrent lesions are difficult to find using CT or MR imaging without the accompanying information provided by PET scans or MR diffusion images.


Image Fusion for Radiosurgery, Neurosurgery and Hypofractionated Radiotherapy.

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

A recurrent neck cancer.MR diffusion images merged to thin-sliced CT axial sections showing a recurrent lesion in the neck, in the same locations as indicated by the PET scan (left line). The Gd-enhanced MR image is fused to CT and used for dose planning (center). The target of hypofractionated radiotherapy is demarcated based on the merged images.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

FIG12: A recurrent neck cancer.MR diffusion images merged to thin-sliced CT axial sections showing a recurrent lesion in the neck, in the same locations as indicated by the PET scan (left line). The Gd-enhanced MR image is fused to CT and used for dose planning (center). The target of hypofractionated radiotherapy is demarcated based on the merged images.
Mentions: PET scanning is usually used to detect recurrences and metastases in follow-up studies of patients with cancers. MR diffusion imaging is also helpful to detect recurrent lesions during radiosurgery, especially recurrent head and neck tumors, as shown in Figure 12. However, the exact site of positive areas is not clearly shown. Image fusion with CT and MR diffusion images will enable the delineation of the target for radiosurgery, as well as PET scanning [17-18]. Direct image fusion of MR diffusion images to thin-sliced CT for radiosurgery is not precise yet. At present, merged images of MR and CT are made, and the target is delineated on the merged images (Figure 12). Then, image fusion of Gd-enhanced MR images to CT is performed for dose planning prior to radiosurgery. The image fusion supported with merged images is useful, especially for patients who received reconstructive surgery after removal of head and neck tumors, because the normal structures are often not shown, and recurrent lesions are difficult to find using CT or MR imaging without the accompanying information provided by PET scans or MR diffusion images.

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