Treatment planning using CT/MRI fusion in patients with low-grade gliomas and benign brain tumors

Full text: Introduction: The use of the CT image without and with contrast in MRI in treatment planning of the clinical target volumes, and critical organs, lead to increased accuracy in radiation therapy. Materials and Methods: From September 2007 to December 2009 in the Department of Radiotherapy CT with and without contrast was applied in 53 patients. After that two dosimetric plans have been developed, which showed minimal advantage in low-grade gliomas because their poor blood supply. This gave us a reason to move to the use of images from MRI without contrast. Next step in the treatment planning was merging images from MRI without contrast with the basic imaging technique in radiotherapy - CT. From January 2010 to March 2013 were prepared individual dosimetric plan 51 ± MRI and the data from the dose- volume histograms and investigated advantages of the method are compared. Results: There was a notable advantage at the confluence of MRI and CT images in the determination of the large tumor volume (LTV) due to better visualization of residual formation compared with CT images. There is an advantage in tumors located in the cerebellum, celery, suprasellar area and the base of the skull, which are an essential part of the studied patients. Depending on the type of the histology the method shows an advantage in low-grade glial tumor excision by R1 and benign tumor. The process has the significant advantage in the medical treatment plan to determine and outline of the tumor volume to that with application of contrast in CT. Conclusion: As a result form the performed studies on the problem, a protocol was developed for treatment planning of patients through simultaneous use of CT and MRI images in low-grade glial and benign tumors as well as tumors located in the rear cranial fossa