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功能性磁共振成像引导的立体射线手术 (fMRI-SRS),以避免有症状的放射性死
Chengcheng Gui1, Mehrnaz Jenabi2, Jillian Daly3
1Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, 1275 York Ave., New York, NY, 10065.
International journal of radiation oncology, biology, physics
|November 30, 2025
概括
功能性磁共振成像 (fMRI) 有助于识别大脑区域,以实现更安全的立体辐射手术 (SRS). 新型fMRI指导的SRS规划可以减少辐射剂量到附近的雄辩区域,从而降低放射性死症状的风险.
科学领域:
- 神经外科 神经外科
- 放射学 放射学是一门学科.
- 神经瘤学神经瘤学
背景情况:
- 与结构成像相比,功能磁共振成像 (fMRI) 提供了雄辩的大脑区域的优越定位,有助于神经外科规划.
- 尽管有好处,但fMRI在脑转移 (BM) 的立体射线手术 (SRS) 中未得到充分利用.
- 这项研究研究了SRS剂量与fMRI识别的雄辩区域和放射性死 (RN) 症状之间的关系.
研究的目的:
- 评估SRS与BM之间的神经解剖学关系,fMRI识别的附近雄辩区域,以及放射性死 (RN) 的症状.
- 评估一种新的fMRI导向SRS (fMRI-SRS) 规划方法在将剂量最小化到雄辩的区域中的有效性.
主要方法:
- 包括在三个月内接受BMS的fMRI患者.
- 最接近的雄辩区域 (NEA) 被定义为fMRI上最接近辐射BM的运动,语言或视觉区域.
- 后勤回归分析了NEA剂量和焦点症状RN (FSRN) 之间的关系;用fMRI-SRS重新规划病例,以最大限度地避免NEA.
主要成果:
- 在93名患者中,12名患有FSRN. 较高的V14Gy (单个分数相当剂量) 与NEA预测增加FSRN风险 (OR6.8/mL,p=0.05) 在接受5分数SRS的患者中.
- 在所有病例中,fMRI-SRS重新规划减少了NEA V14Gy,平均为22.5%.
- 最常见的NEA是运动 (76%),其次是语言 (19%).
结论:
- RN的焦点神经症状与SRS剂量与fMRI识别的雄辩大脑区域交付有关.
- fMRI-SRS计划有效地将辐射剂量最小化到关键的雄辩区域.
- 这种方法有可能在接受SRS治疗的大脑转移的患者中减轻神经毒性.
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