Value of CT-MRI fusion in iodine-125 brachytherapy for high-grade glioma
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Yang Gao1, Yan Han2, Guo Nan1, Man Hu3, Xiaobin Zhou4 and Xiaokun Hu5
1School of Instrumentation Science and Opto-Electronics Engineering, Beihang University, Beijing 100191, China
2Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao 266001, China
3Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Jinan 250117 China
4Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao 266021, China
5Interventional Center, The Affiliated Hospital of Qingdao University, Qingdao 266001, China
Xiaokun Hu, email: [email protected]
Keywords: brachytherapy; image fusion; MRI; CT; high-grade glioma
Received: June 07, 2017 Accepted: November 13, 2017 Published: December 01, 2017
Purposes: To develop a fast, accurate and robust method of fusing Computed Tomography (CT) with pre-operative Magnetic Resonance Imaging (MRI) and evaluate the impact of using the fused data on the implantation of Iodine-125 (125I) seeds for brachytherapy of high-grade gliomas (HGG).
Methods: A study was performed on a cohort of 10 consecutive patients with HGG were treated by 125I brachytherapy with CT-MRI fusion image guided (CMGB), and 10 patients treated with CT alone guided (CGB). Statistical analysis was performed to compare (1) the planning target volume, (2) the accuracy of location of catheters, (3) the target volume covered by 150% prescribe dose (V150), (4) the target volume covered by 200% prescribe dose (V200), and (5) the conformity index (CI) with or without fused data.
Results: The median planning target volume was 50.1 cm3 in CGB, and 56.25 cm3 in CMGB with significant difference (p = 0.005). The accuracy of catheter insertion was 94.4% with CMGB and 78.9% with CGB. The median V150 and V200 was 45.32% vs 64.24% and 32.81% vs 53.17% in CGB and CMGB, respectively. There was significant difference for CI (83.5% vs. 74.5%, p < 0.05) in the two groups for the post-operative verification.
Conclusions: The proposed MRI-CT fusion method enables a quantitative assessment of impact on HGG brachytherapy. The additional information obtained from the fused images can be utilized for more accurate delineation of lesion boundaries and targeting of catheters. Experimental results show that the fusion algorithm is robust and reliable in clinical practice.
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