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Exploration of Diffusion Tensor Imaging for Delineating Target Volume Boundary in Glioblastoma Radiotherapy

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机构: [1]Second Hosp Hebei Med Univ, Dept Radiotherapy, Shijiazhuang, Hebei, Peoples R China [2]Hebei Univ, Affiliated Hosp, Dept Radiotherapy, Baoding, Hebei, Peoples R China
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关键词: ADC DTI FA glioblastoma radiotherapy target volume

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Purpose: The objective of this study is to investigate the variations in diffusion tensor imaging (DTI) parameters at different distances surrounding the operative cavity, with a specific focus on exploring the potential utility of DTI in accurately delineating radiotherapy clinical target volume for glioblastoma patients. Methods: A retrospective study was conducted on 41 patients with glioblastoma, in which apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values were measured at various distances beyond the surgical cavity. Recurrent patients were prospectively followed up according to the RANO criteria, aiming to investigate discrepancies between ADC and FA values in recurrent regions compared to normal control tissues prior to recurrence. Results: The rADC and rFA ratio approach 1 at a distance of 3 cm beyond the cavity. At the edge of the operative cavity and 2 cm beyond, the subtotal resection (STR) group exhibited higher ADC and rADC values compared to the gross total resection (GTR) group (p < 0.05). Similarly, FA and rFA values in the STR group were lower than those in the total resection group both at 1 cm beyond and 2 cm beyond (p < 0.05). Conventional MRI did not reveal any abnormalities prior to marginal or distant recurrence; however, the ADC value within this region was higher than that of control normal tissues (p = 0.023). Conclusions: The margins of GBM tumour invasion are typically not isotropic and could be > 2 cm and sometimes up to 3 cm. We recommend appropriately larger expansion of the target volume for patients with subtotal tumour resection. The utilisation of DTI in delineating the boundary of GBM's radiotherapy clinical target volume represents a promising avenue that holds potential to enhance precision and accuracy.

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大类 | 4 区 医学
小类 | 4 区 核医学
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Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

影响因子: 最新[2024版] 最新五年平均 出版当年[2025版] 出版当年五年平均 出版前一年[2024版]

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第一作者机构: [1]Second Hosp Hebei Med Univ, Dept Radiotherapy, Shijiazhuang, Hebei, Peoples R China
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