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Title: Tolerance of Pyramidal Tract to Gamma Knife Radiosurgery Based on Diffusion-Tensor Tractography

Abstract

Purpose: To minimize the morbidity of radiosurgery for critically located lesions, we integrated diffusion-tensor tractography into treatment planning for gamma-knife radiosurgery. We calculated the refined tolerance of the pyramidal tract (PT) after prospective application of the technique to additional patients. Methods and Materials: The relationship between the dosimetry during treatment planning and the development of subsequent motor complications was investigated in 24 patients, 9 studied retrospectively and 15 studied prospectively. The maximal dose to the PT and the volumes of the PT that received {>=}20 Gy (20-Gy volume) and {>=}25 Gy (25-Gy volume) were calculated. Univariate logistic regression analyses were used to produce dose-response curves. Differences in the tolerable dose according to the PT location were calculated. Results: Univariate logistic regression analysis of the motor complications revealed a significant independent correlation with the maximal dose to the PT and the 20- and 25-Gy volumes. The maximal dose to the PT with a 5% risk of motor complications was 23 Gy compared with 15 Gy in our previous report. The risk of motor complications was significantly greater in the internal capsule than in the corona radiata for the 20- and 25-Gy volumes in generalized Wilcoxon tests (p = 0.031), although nomore » significant difference was observed for the maximal dose. Conclusion: The tolerable dose of the PT was greater than that previously reported. The internal capsule was more sensitive to high-dose irradiation over a wide area of the PT, probably owing to the dense concentration of motor fibers.« less

Authors:
 [1]; ; ;  [1]; ; ; ; ; ;  [2];  [1]
  1. Department of Neurosurgery, University of Tokyo Hospital, Tokyo (Japan)
  2. Department of Radiology, University of Tokyo Hospital, Tokyo (Japan)
Publication Date:
OSTI Identifier:
21124134
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 70; Journal Issue: 5; Other Information: DOI: 10.1016/j.ijrobp.2007.08.010; PII: S0360-3016(07)03871-0; Copyright (c) 2008 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; DOSIMETRY; IRRADIATION; RADIATION DOSES; RADIOTHERAPY; REGRESSION ANALYSIS; SURGERY; TOLERANCE

Citation Formats

Maruyama, Keisuke, Kamada, Kyousuke, Ota, Takahiro, Koga, Tomoyuki, Itoh, Daisuke, Ino, Kenji R.T., Aoki, Shigeki, Tago, Masao, Masutani, Yoshitaka, Shin, Masahiro, and Saito, Nobuhito. Tolerance of Pyramidal Tract to Gamma Knife Radiosurgery Based on Diffusion-Tensor Tractography. United States: N. p., 2008. Web. doi:10.1016/j.ijrobp.2007.08.010.
Maruyama, Keisuke, Kamada, Kyousuke, Ota, Takahiro, Koga, Tomoyuki, Itoh, Daisuke, Ino, Kenji R.T., Aoki, Shigeki, Tago, Masao, Masutani, Yoshitaka, Shin, Masahiro, & Saito, Nobuhito. Tolerance of Pyramidal Tract to Gamma Knife Radiosurgery Based on Diffusion-Tensor Tractography. United States. https://doi.org/10.1016/j.ijrobp.2007.08.010
Maruyama, Keisuke, Kamada, Kyousuke, Ota, Takahiro, Koga, Tomoyuki, Itoh, Daisuke, Ino, Kenji R.T., Aoki, Shigeki, Tago, Masao, Masutani, Yoshitaka, Shin, Masahiro, and Saito, Nobuhito. 2008. "Tolerance of Pyramidal Tract to Gamma Knife Radiosurgery Based on Diffusion-Tensor Tractography". United States. https://doi.org/10.1016/j.ijrobp.2007.08.010.
@article{osti_21124134,
title = {Tolerance of Pyramidal Tract to Gamma Knife Radiosurgery Based on Diffusion-Tensor Tractography},
author = {Maruyama, Keisuke and Kamada, Kyousuke and Ota, Takahiro and Koga, Tomoyuki and Itoh, Daisuke and Ino, Kenji R.T. and Aoki, Shigeki and Tago, Masao and Masutani, Yoshitaka and Shin, Masahiro and Saito, Nobuhito},
abstractNote = {Purpose: To minimize the morbidity of radiosurgery for critically located lesions, we integrated diffusion-tensor tractography into treatment planning for gamma-knife radiosurgery. We calculated the refined tolerance of the pyramidal tract (PT) after prospective application of the technique to additional patients. Methods and Materials: The relationship between the dosimetry during treatment planning and the development of subsequent motor complications was investigated in 24 patients, 9 studied retrospectively and 15 studied prospectively. The maximal dose to the PT and the volumes of the PT that received {>=}20 Gy (20-Gy volume) and {>=}25 Gy (25-Gy volume) were calculated. Univariate logistic regression analyses were used to produce dose-response curves. Differences in the tolerable dose according to the PT location were calculated. Results: Univariate logistic regression analysis of the motor complications revealed a significant independent correlation with the maximal dose to the PT and the 20- and 25-Gy volumes. The maximal dose to the PT with a 5% risk of motor complications was 23 Gy compared with 15 Gy in our previous report. The risk of motor complications was significantly greater in the internal capsule than in the corona radiata for the 20- and 25-Gy volumes in generalized Wilcoxon tests (p = 0.031), although no significant difference was observed for the maximal dose. Conclusion: The tolerable dose of the PT was greater than that previously reported. The internal capsule was more sensitive to high-dose irradiation over a wide area of the PT, probably owing to the dense concentration of motor fibers.},
doi = {10.1016/j.ijrobp.2007.08.010},
url = {https://www.osti.gov/biblio/21124134}, journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 5,
volume = 70,
place = {United States},
year = {Tue Apr 01 00:00:00 EDT 2008},
month = {Tue Apr 01 00:00:00 EDT 2008}
}