An investigation of the conformity, feasibility, and expected clinical benefits of multiparametric MRI-guided dose painting radiotherapy in glioblastoma.

Brighi, Caterina; Keall, Paul J; Holloway, Lois C; Walker, Amy; Whelan, Brendan; de Witt Hamer, Philip C; Verburg, Niels; Aly, Farhannah; Chen, Cathy; Koh, Eng-Siew; Waddington, David E J

Brighi, Caterina; Keall, Paul J; Holloway, Lois C; Walker, Amy; Whelan, Brendan; de Witt Hamer, Philip C; Verburg, Niels; Aly, Farhannah; Chen, Cathy; Koh, Eng-Siew; Waddington, David E J.

Afiliação

Brighi C; ACRF Image X Institute, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
Keall PJ; Ingham Institute for Applied Medical Research, Sydney, Australia.
Holloway LC; ACRF Image X Institute, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
Walker A; Ingham Institute for Applied Medical Research, Sydney, Australia.
Whelan B; Ingham Institute for Applied Medical Research, Sydney, Australia.
de Witt Hamer PC; Department of Radiation Oncology, Liverpool and Macarthur Cancer Therapy Centres, Liverpool, Australia.
Verburg N; Centre for Medical Radiation Physics, University of Wollongong, Wollongong, Australia.
Aly F; Ingham Institute for Applied Medical Research, Sydney, Australia.
Chen C; Department of Radiation Oncology, Liverpool and Macarthur Cancer Therapy Centres, Liverpool, Australia.
Koh ES; Centre for Medical Radiation Physics, University of Wollongong, Wollongong, Australia.
Waddington DEJ; ACRF Image X Institute, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.

Neurooncol Adv ; 4(1): vdac134, 2022.

Article em En | MEDLINE | ID: mdl-36105390

ABSTRACT

ABSTRACT

Background:

New technologies developed to improve survival outcomes for glioblastoma (GBM) continue to have limited success. Recently, image-guided dose painting (DP) radiotherapy has emerged as a promising strategy to increase local control rates. In this study, we evaluate the practical application of a multiparametric MRI model of glioma infiltration for DP radiotherapy in GBM by measuring its conformity, feasibility, and expected clinical benefits against standard of care treatment.

Methods:

Maps of tumor probability were generated from perfusion/diffusion MRI data from 17 GBM patients via a previously developed model of GBM infiltration. Prescriptions for DP were linearly derived from tumor probability maps and used to develop dose optimized treatment plans. Conformity of DP plans to dose prescriptions was measured via a quality factor. Feasibility of DP plans was evaluated by dose metrics to target volumes and critical brain structures. Expected clinical benefit of DP plans was assessed by tumor control probability. The DP plans were compared to standard radiotherapy plans.

Results:

The conformity of the DP plans was >90%. Compared to the standard plans, DP (1) did not affect dose delivered to organs at risk; (2) increased mean and maximum dose and improved minimum dose coverage for the target volumes; (3) reduced minimum dose within the radiotherapy treatment margins; (4) improved local tumor control probability within the target volumes for all patients.