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J Cancer Res Ther. 2019;15(4):818-824. doi: 10.4103/jcrt.JCRT_70_19.

Computed tomography-magnetic resonance imaging fusion-guided iodine-125 seed implantation for single malignant brain tumor: Feasibility and safety.

Author information

1
Center for Interventional Medicine, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
2
Department of Radiology, Zhongda Hospital, Southeast University, Nanjing, Jiangsu, China.
3
Department of Dermatology, Qingdao No. 6 People's Hospital, Qingdao, Shandong, China.
4
Department of Science and Education, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
5
Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, China.

Abstract

Background:

To investigate the feasibility and safety of computed tomography-magnetic resonance imaging (CT-MRI) fusion-guided iodine-125 seed implantation for a single malignant brain tumor.

Methods:

From November 2015 to October 2016, 12 patients with a single malignant brain tumor were treated with permanent iodine-125 seeds implantation. CT-MRI fusion images were used to make the preoperative treatment plan, intraoperative dose optimization, postoperative verification, and tumor response follow-up. The dosimetry parameters of CT-MRI image fusion plans were compared between preprocedures and postprocedures, including plan target volume, V100 (the percentage of the target volume covered by the prescription dose [PD]), D90 (the dose that covers 90% of the target volume), and V200 (the percentage volume of the brain tumor receiving 200% of the PD). Adverse events were graded by the Common Terminology Criteria for Adverse Events. Clinical and radiological follow-ups were performed at a 3-month interval.

Results:

All the interstitial implantations were completed successfully under the guidance of CT-MRI image fusion. The dosimetry parameters of CT-MRI image fusion postplans did not differ significantly from those of preplans (P > 0.05). No higher than Grade 2 adverse events were observed during the follow-up. Tumor control was achieved in 10 of 12 patients (83.33%). The median overall survival time was 15.05 ± 3.35 months (95% confidence interval 12.99-17.26).

Conclusions:

CT-MRI image fusion is feasible for the design, optimization, and verification of treatment planning. CT-MRI fusion-based brachytherapy may improve dosimetry of brain tumor while sparing the normal structures, potentially impacting disease control, treatment-related toxicity, and long-term survival.

KEYWORDS:

Brachytherapy; image fusion; malignant brain tumor

PMID:
31436237
DOI:
10.4103/jcrt.JCRT_70_19
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