Applications of Advanced Imaging for Radiotherapy Planning and Response Assessment in the Central Nervous System.

IF 2.2 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Tomography Pub Date : 2025-06-12 DOI:10.3390/tomography11060068

Liam S P Lawrence, Rachel W Chan, Amit Singnurkar, Jay Detsky, Chris Heyn, Pejman J Maralani, Hany Soliman, Greg J Stanisz, Arjun Sahgal, Angus Z Lau

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引用次数: 0

Abstract

Background/objectives: Radiotherapy for tumors of the central nervous system (CNS) could be improved by incorporating advanced imaging techniques into treatment planning and response assessment. The objective of this narrative review is to highlight the recent developments in magnetic resonance imaging (MRI) and positron emission tomography (PET) for applications in CNS radiotherapy.

Methods: Recent articles were selected for discussion, covering the following topics: advanced imaging on MRI-linear accelerators for early response assessment in glioma; PET for guiding treatment planning and response assessment in glioma; and contrast-enhanced imaging and metabolic imaging for differentiating tumor progression and radiation necrosis for brain metastasis treatment. Where necessary, searches of scholarly databases (e.g., Google Scholar, PubMed) were used to find papers for each topic. The topics were chosen based on the perception of promise in advancing specific applications of CNS radiotherapy and not covered in detail elsewhere. This review is not intended to be comprehensive.

Results: Advanced MRI sequences and PET could have a substantial impact on CNS radiotherapy. For gliomas, the tumor response to therapy could be assessed much earlier than using the conventional technique of measuring changes in tumor size. Using advanced imaging on combined imaging/therapy devices like MR-Linacs would enable response monitoring throughout radiotherapy. For brain metastases, radiation necrosis and tumor progression might be reliably differentiated with imaging techniques sensitive to perfusion or metabolism. However, the lack of level 1 evidence supporting specific uses for each imaging technique is an impediment to widespread use.

Conclusions: Advanced MRI and PET have great promise to change the standard of care for CNS radiotherapy, but clinical trials validating specific applications are needed.

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先进影像技术在中枢神经系统放射治疗计划及疗效评估中的应用。

背景/目的：通过将先进的成像技术纳入治疗计划和反应评估，可以改善中枢神经系统肿瘤的放疗。本文的目的是回顾磁共振成像（MRI）和正电子发射断层扫描（PET）在中枢神经系统放射治疗中的应用的最新进展。方法：选择最近的文章进行讨论，涵盖以下主题：mri线性加速器的高级成像用于胶质瘤的早期反应评估；PET指导胶质瘤治疗方案及疗效评价对比增强成像和代谢成像用于鉴别肿瘤进展和脑转移治疗的放射性坏死。必要时，检索学术数据库（如b谷歌Scholar， PubMed）来查找每个主题的论文。主题的选择是基于对推进中枢神经系统放射治疗具体应用的前景的看法，在其他地方没有详细介绍。这篇综述并不打算是全面的。结果：先进的MRI序列和PET对中枢神经系统放疗有重要影响。对于胶质瘤，可以比使用测量肿瘤大小变化的传统技术更早地评估肿瘤对治疗的反应。在像MR-Linacs这样的联合成像/治疗设备上使用先进的成像技术，将使整个放疗过程中的反应监测成为可能。对于脑转移瘤，放射坏死和肿瘤进展可以通过对灌注或代谢敏感的成像技术可靠地区分。然而，缺乏支持每种成像技术具体用途的一级证据是广泛使用的障碍。结论：先进的MRI和PET有很大的希望改变中枢神经系统放疗的护理标准，但需要临床试验验证具体的应用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Tomography Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

2.70

自引率

10.50%

发文量

222

期刊介绍： TomographyTM publishes basic (technical and pre-clinical) and clinical scientific articles which involve the advancement of imaging technologies. Tomography encompasses studies that use single or multiple imaging modalities including for example CT, US, PET, SPECT, MR and hyperpolarization technologies, as well as optical modalities (i.e. bioluminescence, photoacoustic, endomicroscopy, fiber optic imaging and optical computed tomography) in basic sciences, engineering, preclinical and clinical medicine. Tomography also welcomes studies involving exploration and refinement of contrast mechanisms and image-derived metrics within and across modalities toward the development of novel imaging probes for image-based feedback and intervention. The use of imaging in biology and medicine provides unparalleled opportunities to noninvasively interrogate tissues to obtain real-time dynamic and quantitative information required for diagnosis and response to interventions and to follow evolving pathological conditions. As multi-modal studies and the complexities of imaging technologies themselves are ever increasing to provide advanced information to scientists and clinicians. Tomography provides a unique publication venue allowing investigators the opportunity to more precisely communicate integrated findings related to the diverse and heterogeneous features associated with underlying anatomical, physiological, functional, metabolic and molecular genetic activities of normal and diseased tissue. Thus Tomography publishes peer-reviewed articles which involve the broad use of imaging of any tissue and disease type including both preclinical and clinical investigations. In addition, hardware/software along with chemical and molecular probe advances are welcome as they are deemed to significantly contribute towards the long-term goal of improving the overall impact of imaging on scientific and clinical discovery.