基于MR灌注成像进行脑转移瘤亚靶区分割的研究

doi:10.3760/cma.j.cn113030-20200613-00306

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Abstract Objective To evaluate the feasibility of magnetic resonance (MR) perfusion imaging for sub-region segmentation of brain metastases (BMs), and to provide reference for individualized radiotherapy based on blood flow perfusion heterogeneity in BMs patients. Methods 96 BMs patients were selected, including 55 patients with necrosis and 41 without necrosis. Each patient was scanned with CT simulation and MR simulation before radiotherapy. MIM Maestro 6.8.8software was used to delineate the gross tumor volume (GTV) and necrosis GTV (GTVN) from enhanced T1W images and T2 Propeller images, respectively, and the solid GTV (GTVS) was obtained by the subtraction of the two. Then, the cerebral blood flow map of three dimensional arterial spin labeling (3D-ASL) was employed to determine the high perfused GTV (GTVH) and low perfused GTV (GTVL). The volume and proportion of sub-regions were counted and compared between two groups and the correlation of each sub-region was analyzed. Results The volume of GTV in the necrosis and non-necrosis groups was 19.56 and 7.34cm³, respectively. Besides, the AUC of the ROC between GTV volume and necrosis was 0.749. In the necrosis group, the ratio of GTVN, GTVS, GTVH and GTVL to GTV was 20.47%, 79.53%, 33.03% and 46.50%, respectively (all P<0.05). Among them, the r value between GTVS and GTV was 0.963, 0.849 for GTVL and GTV, and 0.840 for GTVL and GTVS, significantly higher than 0.683 for GTVH and GTV and 0.764 for GTVH and GTVS (all P<0.05). In the non-necrosis group, the ratio of GTVH to GTV was higher than that in the necrosis group (58.95% vs. 33.03%, P<0.05). In addition, the ratio of GTVL to GTV was slightly lower than that in the necrosis group (41.05% vs. 46.50%, P>0.05). The r value between GTVH and GTV was 0.776, significantly higher than 0.574 between GTVL and GTV (P<0.05). Conclusion MR-3D-ASL can quantitatively analyze the heterogeneous blood perfusion of BMs, which could guide the sub-region segmentation and local dose escalation of tumors.

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	Hou Chuanke
	Gong Guanzhong
	Wang Lizhen
	Su Ya
	Lu Jie
	Yin Yong

Key words： Magnetic resonance imaging Three dimensional arterial spin labeling perfusion Sub-region segmentation Neoplasm metastasis,brain/radiotherapy

Received: 13 June 2020

Fund:Clinical Research and Cultivation Project of Shandong Cancer Hospital (YYPY2020-016)

Corresponding Authors: Yin Yong, Email:yinyongsd@126.com

Cite this article:

Hou Chuanke,Gong Guanzhong,Wang Lizhen et al. Study of sub-region segmentation of brain metastases based on magnetic resonance perfusion imaging[J]. Chinese Journal of Radiation Oncology, 2021, 30(10): 1047-1053.

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http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.cn113030-20200613-00306 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2021/V30/I10/1047

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