Colman, J;
Mancini, L;
Manolopoulos, S;
Gupta, M;
Kosmin, M;
Bisdas, S;
(2022)
Is Diffusion Tensor Imaging-Guided Radiotherapy the New State-of-the-Art? A Review of the Current Literature and Technical Insights.
Applied Sciences
, 12
(2)
, Article 816. 10.3390/app12020816.
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Abstract
Despite the increasing precision of radiotherapy delivery, it is still frequently associated with neurological complications. This is in part due to damage to eloquent white matter (WM) tracts, which is made more likely by the fact they cannot be visualised on standard structural imaging. WM is additionally more vulnerable than grey matter to radiation damage. Primary brain malignancies also are known to spread along the WM. Diffusion tensor imaging (DTI) is the only in vivo method of delineating WM tracts. DTI is an imaging technique that models the direction of diffusion and therefore can infer the orientation of WM fibres. This review article evaluates the current evidence for using DTI to guide intracranial radiotherapy and whether it constitutes a new state-of-the-art technique. We provide a basic overview of DTI and its known applications in radiotherapy, which include using tractography to reduce the radiation dose to eloquent WM tracts and using DTI to detect or predict tumoural spread. We evaluate the evidence for DTI-guided radiotherapy in gliomas, metastatic disease, and benign conditions, finding that the strongest evidence is for its use in arteriovenous malformations. However, the evidence is weak in other conditions due to a lack of case-controlled trials.
| Type: | Article |
|---|---|
| Title: | Is Diffusion Tensor Imaging-Guided Radiotherapy the New State-of-the-Art? A Review of the Current Literature and Technical Insights |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.3390/app12020816 |
| Publisher version: | https://doi.org/10.3390/app12020816 |
| Language: | English |
| Additional information: | : © 2022 by the authors. Li‐ censee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and con‐ ditions of the Creative Commons At‐ tribution (CC BY) license (https://cre‐ ativecommons.org/licenses/by/4.0/). |
| Keywords: | stereotactic radiotherapy; image-guided radiotherapy; diffusion tensor imaging |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology UCL > Provost and Vice Provost Offices > UCL BEAMS UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Med Phys and Biomedical Eng |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10141971 |
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