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This Article Full Text Full Text (PDF) All Versions of this Article: 10/4/583    most recent 15228517-2008-027v1 Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Julow, J. Articles by Kolumbán, G. PubMed PubMed Citation

Prediction of volumetric change in the "triple ring" caused by glioma I-125 brachytherapy

Jen Julow, Zsuzsa Kolumbán, Árpád Viola, Tibor Major and Géza Kolumbán

Department of Neurosurgery, St. John's Hospital, Budapest, Hungary (J.J., Z.K., Á.V.); Medical School, Semmelweis University, Budapest, Hungary (J.J., Z.K.); Department of Radiotherapy, National Institute of Oncology, Budapest, Hungary (T.M.); Department of Measurement and Information Systems, Budapest University of Technology and Economics, Budapest, Hungary (G.K.)

Address correspondence to Jen Julow, Department of Neurosurgery, St. John's Hospital, Diósárok u. 1-3, 1125 Budapest, Hungary (h12494jul{at}ella.hu).

The aim of this study was to reveal the volumetric changes in tumor necrosis, reactive zone, and edema referred to as the "triple ring" appearing after low-dose-rate iodine-125 (I-125) interstitial irradiation of 20 inoperable low-grade gliomas. To enable prediction of these volumetric changes, we provide mathematical expressions that describe the dynamics of the triple ring. Volumes of the three regions on image-fused control CT/MR images were measured for a 24-month period. The delivered dose on the tumor surface was 50-60 Gy. Dose planning and image fusion were performed with Brain-Lab Target 1.19 software; mathematical and statistical computations were carried out with Matlab numeric computation and visualization software. To determine the volumes, control images with the triple rings were fused with the planning images. Relative volumes normalized with respect to the volume of reference dose were calculated and plotted in the time domain. First, the mean values of volumes were determined from the patients' measured data; then, polynomials were fitted to the mean values using the polynomial curve-fitting method. The accuracy of our results was verified by correlating the predicted data with the measured ones. The polynomial prediction approach proposed here reveals the dynamics of the triple ring. These polynomials will assist with (1) designing the best treatment, (2) following the patient's condition, and (3) planning reirradiation if necessary.

Key Words: dynamics of the triple ring • interstitial I-125 brachytherapy • low-grade gliomas • predictions for treatment planning • volumetric analysis using image fusion