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Diehl, C. ; Rosenkranz, E.* ; Schwendner, M.J.* ; Mißlbeck, M.* ; Sollmann, N.* ; Ille, S.* ; Meyer, B.* ; Combs, S.E. ; Krieg, S.M.*

Dose reduction to motor structures in adjuvant fractionated stereotactic radiotherapy of brain metastases: nTMS-derived DTI-based motor fiber tracking in treatment planning.

Cancers 15:282 (2023)
Verlagsversion Forschungsdaten DOI PMC
Open Access Gold
Creative Commons Lizenzvertrag
BACKGROUND: Resection of brain metastases (BM) close to motor structures is challenging for treatment. Navigated transcranial magnetic stimulation (nTMS) motor mapping, combined with diffusion tensor imaging (DTI)-based fiber tracking (DTI-FTmot.TMS), is a valuable tool in neurosurgery to preserve motor function. This study aimed to assess the practicability of DTI-FTmot.TMS for local adjuvant radiotherapy (RT) planning of BM. METHODS: Presurgically generated DTI-FTmot.TMS-based corticospinal tract (CST) reconstructions (FTmot.TMS) of 24 patients with 25 BM resected during later surgery were incorporated into the RT planning system. Completed fractionated stereotactic intensity-modulated RT (IMRT) plans were retrospectively analyzed and adapted to preserve FTmot.TMS. RESULTS: In regular plans, mean dose (Dmean) of complete FTmot.TMS was 5.2 ± 2.4 Gy. Regarding planning risk volume (PRV-FTTMS) portions outside of the planning target volume (PTV) within the 17.5 Gy (50%) isodose line, the DTI-FTmot.TMS Dmean was significantly reduced by 33.0% (range, 5.9-57.6%) from 23.4 ± 3.3 Gy to 15.9 ± 4.7 Gy (p < 0.001). There was no significant decline in the effective treatment dose, with PTV Dmean 35.6 ± 0.9 Gy vs. 36.0 ± 1.2 Gy (p = 0.063) after adaption. CONCLUSIONS: The DTI-FTmot.TMS-based CST reconstructions could be implemented in adjuvant IMRT planning of BM. A significant dose reduction regarding motor structures within critical dose levels seems possible.
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Publikationstyp Artikel: Journalartikel
Dokumenttyp Wissenschaftlicher Artikel
Schlagwörter Brain Metastases ; Fiber Tracking ; Stereotactic Fractionated Radiotherapy; Transcranial Magnetic Stimulation; Surgical Resection; Single Metastases; Comparative Risk; Radiosurgery; Cavity; Conformity; Diagnosis; Surgery; Index
Sprache englisch
Veröffentlichungsjahr 2023
Prepublished im Jahr 2022
HGF-Berichtsjahr 2022
ISSN (print) / ISBN 2072-6694
Zeitschrift Cancers
Quellenangaben Band: 15, Heft: 1, Seiten: , Artikelnummer: 282 Supplement: ,
Verlag MDPI
Verlagsort St Alban-anlage 66, Ch-4052 Basel, Switzerland
Begutachtungsstatus Peer reviewed
Institut(e) Institute of Radiation Medicine (IRM)
POF Topic(s) 30203 - Molecular Targets and Therapies
Forschungsfeld(er) Radiation Sciences
PSP-Element(e) G-501300-001
DOI 10.3390/cancers15010282
WOS ID 000913334400001
WOS ID WOS:000913334400001
Scopus ID 85145885508
PubMed ID 36612277
Erfassungsdatum 2023-01-19
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