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首页> 外文期刊>Neurosurgical focus >Integration of functional neuroimaging in CyberKnife radiosurgery: feasibility and dosimetric results
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Integration of functional neuroimaging in CyberKnife radiosurgery: feasibility and dosimetric results

机译：功能神经影像学在射波刀放射外科中的整合：可行性和剂量学结果

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Object The integration of state-of-the-art neuroimaging into treatment planning may increase the therapeutic potential of stereotactic radiosurgery. Functional neuroimaging, including functional MRI, navigated brain stimulation, and diffusion tensor imaging–based tractography, may guide the orientation of radiation beams to decrease the dose to critical cortical and subcortical areas. The authors describe their method of integrating functional neuroimaging technology into radiosurgical treatment planning using the CyberKnife radiosurgery system. Methods The records of all patients who had undergone radiosurgery for brain lesions at the CyberKnife Center of the University of Messina, Italy, between July 2010 and July 2012 were analyzed. Among patients with brain lesions in critical areas, treatment planning with the integration of functional neuroimaging was performed in 25 patients. Morphological and functional imaging data sets were coregistered using the Multiplan dedicated treatment planning system. Treatment planning was initially based on morphological data; radiation dose distribution was then corrected in relation to the functionally relevant cortical and subcortical areas. The change in radiation dose distribution was then calculated. Results The data sets could be easily and reliably integrated into the Cyberknife treatment planning. Using an inverse planning algorithm, the authors achieved an average 17% reduction in the radiation dose to functional areas. Further gain in terms of dose sparing compromised other important treatment parameters, including target coverage, conformality index, and number of monitor units. No neurological deficit due to radiation was recorded at the short-term follow-up. Conclusions Radiosurgery treatments rely on the quality of neuroimaging. The integration of functional data allows a reduction in radiation doses to functional organs at risk, including critical cortical areas, subcortical tracts, and vascular structures. The relative simplicity of integrating functional neuroimaging into radiosurgery warrants further research to implement, standardize, and identify the limits of this procedure.
机译：目的将最新的神经影像技术整合到治疗计划中可能会增加立体定向放射外科手术的治疗潜力。功能性神经影像学，包括功能性MRI，导航性脑刺激以及基于扩散张量成像的放射线照相术，可指导放射束的方向，以减少对关键皮层和皮层下区域的剂量。作者介绍了他们使用Cyber​​Knife放射外科系统将功能性神经影像技术整合到放射外科治疗计划中的方法。方法分析2010年7月至2012年7月在意大利墨西拿大学电子刀中心接受脑部放射外科手术的所有患者的记录。在关键区域有脑部病变的患者中，有25例患者进行了功能神经影像学整合治疗计划。使用Multiplan专用治疗计划系统共同注册了形态学和功能成像数据集。治疗计划最初是基于形态学数据。然后针对功能相关的皮质和皮质下区域校正放射剂量分布。然后计算辐射剂量分布的变化。结果数据集可以轻松可靠地集成到射波刀治疗计划中。使用逆向计划算法，作者将对功能区域的辐射剂量平均降低了17％。在节省剂量方面的进一步获得损害了其他重要的治疗参数，包括靶标覆盖率，保形指数和监测单元的数量。在短期随访中未记录到因放射引起的神经功能缺损。结论放射外科治疗依赖于神经成像质量。功能数据的集成可以减少对处于危险中的功​​能器官（包括关键皮层区域，皮层下管道和血管结构）的辐射剂量。将功能性神经影像学整合到放射外科中的相对简单性值得进一步研究以实施，标准化和确定该程序的局限性。

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