Clinical application of diffusion tensor imaging in postoperative in-tensity modulated radiotherapy for gliomas / 中国肿瘤临床

ABSTRACT

Objective:To evaluate the application value of diffusion tensor imaging (DTI) in guiding the postoperative radiothera-py plan of the gliomas adjacent to the corticospinal tract (CST). Methods:Thirty patients with gliomas adjacent to the CST underwent routine magnetic resonance imaging (MRI) contrast-enhanced scanning and DTI after radiotherapy. Tractography data sets were ac-quired and were fused with the images of corresponding anatomical MRI and computed tomography. The acquired data sets of radio-therapy planning system were imported to assist with the delineation of the target volume, organs at risk, and CST. Two sets of radio-therapy plan, which considered or did not consider the dose protective effect of the CST, were formulated and compared using the treat-ment technique of intensity modulated radiotherapy. Results:The protective radiotherapy and unprotected plans both achieved the thera-peutic dose to the target volume and the protection of the routine organs at risk. In the protective dose (with an optimization program that considered the dose reduction of CST), the maximum and mean radiation doses suffered by the patients' ipsilateral and contra-later-al CSTs were lower compared with the unprotected plan (P<0.05). Conclusion:DTI can identify the location and shape of CSTs, and their relationship with the postoperative radiotherapy target of gliomas. These findings contribute to the formulation of a protective ra-diotherapeutic regimen to keep the CST from the maximum and the mean radiation doses to the largest extent, thereby decreasing the possibility of nerve damage after radiotherapy.