Three-Dimensional Arterial Spin Labeling-Guided Sub-Volume Segmentation of Radiotherapy in Adult Non-Enhancing Low-Grade Gliomas

ObjectiveThe present study aimed to evaluate the feasibility of sub-volume segmentation for radiotherapy planning of adult non-enhancing low-grade gliomas (NE-LGGs) guided by three-dimensional arterial spin labeling (3D-ASL). The differences in high- and low-perfusion areas of NE-LGGs were analyzed...

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Main Authors: Zihong Zhu, Guanzhong Gong, Lizhen Wang, Ya Su, Jie Lu, Yong Yin
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-07-01
Series:Frontiers in Oncology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2022.914507/full
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author Zihong Zhu
Zihong Zhu
Guanzhong Gong
Lizhen Wang
Ya Su
Jie Lu
Yong Yin
Yong Yin
author_facet Zihong Zhu
Zihong Zhu
Guanzhong Gong
Lizhen Wang
Ya Su
Jie Lu
Yong Yin
Yong Yin
author_sort Zihong Zhu
collection DOAJ
description ObjectiveThe present study aimed to evaluate the feasibility of sub-volume segmentation for radiotherapy planning of adult non-enhancing low-grade gliomas (NE-LGGs) guided by three-dimensional arterial spin labeling (3D-ASL). The differences in high- and low-perfusion areas of NE-LGGs were analyzed using multi-sequence magnetic resonance imaging (MRI) radiomics.MethodsFifteen adult patients with NE-LGGs were included in the study. MR images, including T1-weighted imaging (T1WI), T2 Propeller, T2 fluid-attenuated inversion recovery (T2 Flair), 3D-ASL, and contrast-enhanced T1WI (CE-T1WI), were obtained. The gross tumor volume (GTV) was delineated according to the hyperintensity on T2 Flair. The GTV was divided into high- and low-perfusion areas, namely GTV-ASL and GTV-SUB, respectively, based on the differences in cerebral blood flow (CBF) value. The volumes and CBF values of high- and low-perfusion areas were measured and compared. The least absolute shrinkage and selection operator (LASSO) regression was used to select the optimal features of all MR maps. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic accuracy of the absolute CBFmean (aCBFmean), relative CBFmean (rCBFmean, normalized by the CBF value of the normal gray matter), and screened features in differentiating high- and low-perfusion areas.ResultsAmong the enrolled patients, three (20%) patients with NE-LGGs showed focal intra- and post-radiotherapy contrast enhancement within a prior high-perfusion area of 3D-ASL. The volume ratio of the GTV-ASL to the GTV was (37.08% ± 17.88)% (46.26 ± 44.51 vs. 167.46 ± 209.64 cm3, P = 0.000). The CBFmean in the high-perfusion area was approximately two times of that in the edema area or normal gray matter (66.98 ± 18.03 vs. 35.19 ± 7.75 or 33.92 ± 8.48 ml/100g/min, P = 0.000). Thirteen features were screened, seven of which were extracted from 3D-ASL. The area undercurve (AUC) values of aCBFmean, rCBFmean, and firstorder_10Percentile from 3D-ASL were more than 0.9, of which firstorder_10Percentile was the highest. Their cut-off values were 44.16 ml/100 g/min, 1.49 and 31, respectively.ConclusionThe difference in blood perfusion in the GTV can be quantified and analyzed based on 3D-ASL images for NE-LGGs, which could guide the sub-volume segmentation of the GTV. 3D-ASL should become a routine method for NE-LGGs during simulation and radiotherapy.
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spelling doaj.art-41b30aa8edd94b018074d7a8afa8a1982022-12-22T01:20:41ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-07-011210.3389/fonc.2022.914507914507Three-Dimensional Arterial Spin Labeling-Guided Sub-Volume Segmentation of Radiotherapy in Adult Non-Enhancing Low-Grade GliomasZihong Zhu0Zihong Zhu1Guanzhong Gong2Lizhen Wang3Ya Su4Jie Lu5Yong Yin6Yong Yin7Department of Oncology, Affiliated Hospital of Southwest Medical University, Luzhou, ChinaDepartment of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, ChinaDepartment of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, ChinaDepartment of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, ChinaDepartment of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, ChinaDepartment of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, ChinaDepartment of Oncology, Affiliated Hospital of Southwest Medical University, Luzhou, ChinaDepartment of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, ChinaObjectiveThe present study aimed to evaluate the feasibility of sub-volume segmentation for radiotherapy planning of adult non-enhancing low-grade gliomas (NE-LGGs) guided by three-dimensional arterial spin labeling (3D-ASL). The differences in high- and low-perfusion areas of NE-LGGs were analyzed using multi-sequence magnetic resonance imaging (MRI) radiomics.MethodsFifteen adult patients with NE-LGGs were included in the study. MR images, including T1-weighted imaging (T1WI), T2 Propeller, T2 fluid-attenuated inversion recovery (T2 Flair), 3D-ASL, and contrast-enhanced T1WI (CE-T1WI), were obtained. The gross tumor volume (GTV) was delineated according to the hyperintensity on T2 Flair. The GTV was divided into high- and low-perfusion areas, namely GTV-ASL and GTV-SUB, respectively, based on the differences in cerebral blood flow (CBF) value. The volumes and CBF values of high- and low-perfusion areas were measured and compared. The least absolute shrinkage and selection operator (LASSO) regression was used to select the optimal features of all MR maps. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic accuracy of the absolute CBFmean (aCBFmean), relative CBFmean (rCBFmean, normalized by the CBF value of the normal gray matter), and screened features in differentiating high- and low-perfusion areas.ResultsAmong the enrolled patients, three (20%) patients with NE-LGGs showed focal intra- and post-radiotherapy contrast enhancement within a prior high-perfusion area of 3D-ASL. The volume ratio of the GTV-ASL to the GTV was (37.08% ± 17.88)% (46.26 ± 44.51 vs. 167.46 ± 209.64 cm3, P = 0.000). The CBFmean in the high-perfusion area was approximately two times of that in the edema area or normal gray matter (66.98 ± 18.03 vs. 35.19 ± 7.75 or 33.92 ± 8.48 ml/100g/min, P = 0.000). Thirteen features were screened, seven of which were extracted from 3D-ASL. The area undercurve (AUC) values of aCBFmean, rCBFmean, and firstorder_10Percentile from 3D-ASL were more than 0.9, of which firstorder_10Percentile was the highest. Their cut-off values were 44.16 ml/100 g/min, 1.49 and 31, respectively.ConclusionThe difference in blood perfusion in the GTV can be quantified and analyzed based on 3D-ASL images for NE-LGGs, which could guide the sub-volume segmentation of the GTV. 3D-ASL should become a routine method for NE-LGGs during simulation and radiotherapy.https://www.frontiersin.org/articles/10.3389/fonc.2022.914507/fulllow-grade gliomasnon-enhancingsub-volume segmentationthree-dimensional arterial spin labelingradiomics
spellingShingle Zihong Zhu
Zihong Zhu
Guanzhong Gong
Lizhen Wang
Ya Su
Jie Lu
Yong Yin
Yong Yin
Three-Dimensional Arterial Spin Labeling-Guided Sub-Volume Segmentation of Radiotherapy in Adult Non-Enhancing Low-Grade Gliomas
Frontiers in Oncology
low-grade gliomas
non-enhancing
sub-volume segmentation
three-dimensional arterial spin labeling
radiomics
title Three-Dimensional Arterial Spin Labeling-Guided Sub-Volume Segmentation of Radiotherapy in Adult Non-Enhancing Low-Grade Gliomas
title_full Three-Dimensional Arterial Spin Labeling-Guided Sub-Volume Segmentation of Radiotherapy in Adult Non-Enhancing Low-Grade Gliomas
title_fullStr Three-Dimensional Arterial Spin Labeling-Guided Sub-Volume Segmentation of Radiotherapy in Adult Non-Enhancing Low-Grade Gliomas
title_full_unstemmed Three-Dimensional Arterial Spin Labeling-Guided Sub-Volume Segmentation of Radiotherapy in Adult Non-Enhancing Low-Grade Gliomas
title_short Three-Dimensional Arterial Spin Labeling-Guided Sub-Volume Segmentation of Radiotherapy in Adult Non-Enhancing Low-Grade Gliomas
title_sort three dimensional arterial spin labeling guided sub volume segmentation of radiotherapy in adult non enhancing low grade gliomas
topic low-grade gliomas
non-enhancing
sub-volume segmentation
three-dimensional arterial spin labeling
radiomics
url https://www.frontiersin.org/articles/10.3389/fonc.2022.914507/full
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