In silico study of pseudoprogression in glioblastoma:
collaboration of radiologists and radiation oncologists in the
estimation of extent of high dose RT region

J 2020

In silico study of pseudoprogression in glioblastoma: collaboration of radiologists and radiation oncologists in the estimation of extent of high dose RT region

BELANOVÁ, Renata, Andrea ŠPRLÁKOVÁ-PUKOVÁ, Michal STANDARA, Eva JANŮ, Renata KOUKALOVÁ et. al.

Basic information

Original name

In silico study of pseudoprogression in glioblastoma: collaboration of radiologists and radiation oncologists in the estimation of extent of high dose RT region

Authors

BELANOVÁ, Renata (203 Czech Republic, belonging to the institution), Andrea ŠPRLÁKOVÁ-PUKOVÁ (203 Czech Republic, belonging to the institution), Michal STANDARA (203 Czech Republic), Eva JANŮ (203 Czech Republic, belonging to the institution), Renata KOUKALOVÁ (203 Czech Republic, belonging to the institution), Jan KŘÍSTEK (203 Czech Republic, belonging to the institution), Petr BURKOŇ (203 Czech Republic, belonging to the institution), Ivana KOLOUŠKOVÁ (203 Czech Republic, belonging to the institution), Tomáš PROCHÁZKA (203 Czech Republic, belonging to the institution), Petr POSPÍŠIL (203 Czech Republic, belonging to the institution), Arnab CHAKRAVARTI, Pavel ŠLAMPA (203 Czech Republic, belonging to the institution), Ondřej SLABÝ (203 Czech Republic, belonging to the institution) and Tomáš KAZDA (203 Czech Republic, guarantor, belonging to the institution)

Edition

Biomedical Papers, Olomouc, Palacky University, 2020, 1213-8118

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30224 Radiology, nuclear medicine and medical imaging

Country of publisher

Czech Republic

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 1.245

RIV identification code

RIV/00216224:14110/20:00118197

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.5507/bp.2019.039

UT WoS

000595645600013

Keywords in English

pseudoprogression; RANO; glioblastoma; radiotherapy; high-dose field

Abstract

V originále

Background and Aim. Oncologists play a vital role in the interpretation of radiographic results in glioblastoma patients. Molecular pathology and information on radiation treatment protocols among others are all important for accurate interpretation of radiology images. One important issue that may arise in interpreting such images is the phenomenon of tumor "pseudoprogression"; oncologists need to be able to distinguish this effect from true disease progression. Exact knowledge about the location of high-dose radiotherapy region is needed for valid determination of pseudoprogression according to RANO (Response Assessment in Neuro-Oncology) criteria in neurooncology. The aim of the present study was to evaluate the radiologists' understanding of a radiotherapy high-dose region in routine clinical practice since radiation oncologists do not always report 3-dimensional isodoses when ordering follow up imaging. Methods. Eight glioblastoma patients who underwent postresection radiotherapy were included in this study. Four radiologists worked with their pre-radiotherapy planning MR, however, they were blinded to RT target volumes which were defined by radiation oncologists according to current guidelines. The aim was to draw target volume for high dose RT fields (that is the region, where they would consider that there may be a pseudoprogression in future MRI scans). Many different indices describing structure differences were analyzed in comparison with original per-protocol RT target volumes. Results. The median volume for RT high dose field was 277 ccm (range 218 to 401 ccm) as defined per protocol by radiation oncologist and 87 ccm (range 32-338) as defined by radiologists (median difference of paired difference 31%, range 15-112%).The Median Dice index of similarity was 0.46 (range 0.14- 0.78), the median Hausdorff distance 25 mm. Conclusion. Continuing effort to improve education on specific procedures in RT and in radiology as well as automatic tools for exporting RT targets is needed in order to increase specificity and sensitivity in response evaluation.

Links

LQ1601, research and development project

Name: CEITEC 2020 (Acronym: CEITEC2020)

Investor: Ministry of Education, Youth and Sports of the CR

NV18-03-00398, research and development project

Name: Rozšíření současných prognostických skórovacích systémů u mozkových metastáz o mikroRNA profilování s cílem individualizace pooperační péče

Investor: Ministry of Health of the CR, Extension of established prognostic scores in brain metastases by microRNA profiling to tailor the post-operative personalized care

NV18-03-00469, research and development project

Name: Reakce neuronální populace hipokampu na stereotaktickou radioterapii extratemporálních mozkových metastáz: vliv na neurokognitivní funkce a zachování kvality života

Investor: Ministry of Health of the CR

Citovat

BELANOVÁ, Renata, Andrea ŠPRLÁKOVÁ-PUKOVÁ, Michal STANDARA, Eva JANŮ, Renata KOUKALOVÁ, Jan KŘÍSTEK, Petr BURKOŇ, Ivana KOLOUŠKOVÁ, Tomáš PROCHÁZKA, Petr POSPÍŠIL, Arnab CHAKRAVARTI, Pavel ŠLAMPA, Ondřej SLABÝ and Tomáš KAZDA. In silico study of pseudoprogression in glioblastoma: collaboration of radiologists and radiation oncologists in the estimation of extent of high dose RT region. Biomedical Papers. Olomouc: Palacky University, 2020, vol. 164, No 3, p. 307-313. ISSN 1213-8118. Available from: https://dx.doi.org/10.5507/bp.2019.039.

@article{1743640,
   author = {Belanová, Renata and ŠprlákováandPuková, Andrea and Standara, Michal and Janů, Eva and Koukalová, Renata and Křístek, Jan and Burkoň, Petr and Koloušková, Ivana and Procházka, Tomáš and Pospíšil, Petr and Chakravarti, Arnab and Šlampa, Pavel and Slabý, Ondřej and Kazda, Tomáš},
   article_location = {Olomouc},
   article_number = {3},
   doi = {http://dx.doi.org/10.5507/bp.2019.039},
   keywords = {pseudoprogression; RANO; glioblastoma; radiotherapy; high-dose field},
   language = {eng},
   issn = {1213-8118},
   journal = {Biomedical Papers},
   title = {In silico study of pseudoprogression in glioblastoma: collaboration of radiologists and radiation oncologists in the estimation of extent of high dose RT region},
   url = {https://biomed.papers.upol.cz/pdfs/bio/2020/03/13.pdf},
   volume = {164},
   year = {2020}
}

TY  - JOUR
ID  - 1743640
AU  - Belanová, Renata - Šprláková-Puková, Andrea - Standara, Michal - Janů, Eva - Koukalová, Renata - Křístek, Jan - Burkoň, Petr - Koloušková, Ivana - Procházka, Tomáš - Pospíšil, Petr - Chakravarti, Arnab - Šlampa, Pavel - Slabý, Ondřej - Kazda, Tomáš
PY  - 2020
TI  - In silico study of pseudoprogression in glioblastoma: collaboration of radiologists and radiation oncologists in the estimation of extent of high dose RT region
JF  - Biomedical Papers
VL  - 164
IS  - 3
SP  - 307-313
EP  - 307-313
PB  - Palacky University
SN  - 12138118
KW  - pseudoprogression
KW  - RANO
KW  - glioblastoma
KW  - radiotherapy
KW  - high-dose field
UR  - https://biomed.papers.upol.cz/pdfs/bio/2020/03/13.pdf
L2  - https://biomed.papers.upol.cz/pdfs/bio/2020/03/13.pdf
N2  - Background and Aim. Oncologists play a vital role in the interpretation of radiographic results in glioblastoma patients. Molecular pathology and information on radiation treatment protocols among others are all important for accurate interpretation of radiology images. One important issue that may arise in interpreting such images is the phenomenon of tumor "pseudoprogression"; oncologists need to be able to distinguish this effect from true disease progression. Exact knowledge about the location of high-dose radiotherapy region is needed for valid determination of pseudoprogression according to RANO (Response Assessment in Neuro-Oncology) criteria in neurooncology. The aim of the present study was to evaluate the radiologists' understanding of a radiotherapy high-dose region in routine clinical practice since radiation oncologists do not always report 3-dimensional isodoses when ordering follow up imaging. Methods. Eight glioblastoma patients who underwent postresection radiotherapy were included in this study. Four radiologists worked with their pre-radiotherapy planning MR, however, they were blinded to RT target volumes which were defined by radiation oncologists according to current guidelines. The aim was to draw target volume for high dose RT fields (that is the region, where they would consider that there may be a pseudoprogression in future MRI scans). Many different indices describing structure differences were analyzed in comparison with original per-protocol RT target volumes. Results. The median volume for RT high dose field was 277 ccm (range 218 to 401 ccm) as defined per protocol by radiation oncologist and 87 ccm (range 32-338) as defined by radiologists (median difference of paired difference 31%, range 15-112%).The Median Dice index of similarity was 0.46 (range 0.14- 0.78), the median Hausdorff distance 25 mm. Conclusion. Continuing effort to improve education on specific procedures in RT and in radiology as well as automatic tools for exporting RT targets is needed in order to increase specificity and sensitivity in response evaluation.
ER  -

BELANOVÁ, Renata, Andrea ŠPRLÁKOVÁ-PUKOVÁ, Michal STANDARA, Eva JANŮ, Renata KOUKALOVÁ, Jan KŘÍSTEK, Petr BURKOŇ, Ivana KOLOUŠKOVÁ, Tomáš PROCHÁZKA, Petr POSPÍŠIL, Arnab CHAKRAVARTI, Pavel ŠLAMPA, Ondřej SLABÝ and Tomáš KAZDA. In silico study of pseudoprogression in glioblastoma: collaboration of radiologists and radiation oncologists in the estimation of extent of high dose RT region. \textit{Biomedical Papers}. Olomouc: Palacky University, 2020, vol.~164, No~3, p.~307-313. ISSN~1213-8118. Available from: https://dx.doi.org/10.5507/bp.2019.039.

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