Pang, Yaru;
Kosmin, Michael;
Li, Zhuangling;
Deng, Xiaonian;
Li, Zihuang;
Li, Xianming;
Zhang, Ying;
... Manolopoulos, Spyros; + view all
(2023)
Isotoxic dose escalated radiotherapy for glioblastoma based on diffusion-weighted MRI and tumor control probability—an in-silico study.
British Journal of Radiology
, 96
(1146)
, Article 20220384. 10.1259/bjr.20220384.
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Abstract
OBJECTIVES: Glioblastoma (GBM) is the most common malignant primary brain tumor with local recurrence after radiotherapy (RT), the most common mode of failure. Standard RT practice applies the prescription dose uniformly across tumor volume disregarding radiological tumor heterogeneity. We present a novel strategy using diffusion-weighted (DW-) MRI to calculate the cellular density within the gross tumor volume (GTV) in order to facilitate dose escalation to a biological target volume (BTV) to improve tumor control probability (TCP). METHODS: The pre-treatment apparent diffusion coefficient (ADC) maps derived from DW-MRI of ten GBM patients treated with radical chemoradiotherapy were used to calculate the local cellular density based on published data. Then, a TCP model was used to calculate TCP maps from the derived cell density values. The dose was escalated using a simultaneous integrated boost (SIB) to the BTV, defined as the voxels for which the expected pre-boost TCP was in the lowest quartile of the TCP range for each patient. The SIB dose was chosen so that the TCP in the BTV increased to match the average TCP of the whole tumor. RESULTS: By applying a SIB of between 3.60 Gy and 16.80 Gy isotoxically to the BTV, the cohort's calculated TCP increased by a mean of 8.44% (ranging from 7.19 to 16.84%). The radiation dose to organ at risk is still under their tolerance. CONCLUSIONS: Our findings indicate that TCPs of GBM patients could be increased by escalating radiation doses to intratumoral locations guided by the patient's biology (i.e., cellularity), moreover offering the possibility for personalized RT GBM treatments. ADVANCES IN KNOWLEDGE: A personalized and voxel level SIB radiotherapy method for GBM is proposed using DW-MRI, which can increase the tumor control probability and maintain organ at risk dose constraints.
| Type: | Article |
|---|---|
| Title: | Isotoxic dose escalated radiotherapy for glioblastoma based on diffusion-weighted MRI and tumor control probability—an in-silico study |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1259/bjr.20220384 |
| Publisher version: | http://doi.org/10.1259/bjr.20220384 |
| Language: | English |
| Additional information: | Copyright © 2023 The Authors. Published by the British Institute of Radiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 Unported License http://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted non-commercial reuse, provided the original author and source are credited. |
| UCL classification: | UCL 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/10169801 |
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