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Advanced MR Imaging acquisition and analysis for assessment of toxicity after radiation therapy in primary brain tumors

Summary of the Project

The aim of this project is to investigate the effect of photon- versus proton-beam radiation therapy for primary brain tumor patients on tumor tissue and surrounding brain tissue using advanced Magnetic Resonance Imaging (MRI) methods. The ultimate goal is to establish a rationale for proton beam therapy in primary brain tumor patients with a long-term life-expectancy at risk of developing radiation sequelae.

After establishment of an advanced MRI protocol, all primary brain tumor patients treated with photon-/proton-(chemo)radiotherapy at the University Hospital Carl Gustav Carus Dresden will prospectively be imaged pre-(chemo)radiotherapy and at three-monthly intervals thereafter. MR changes will be qualitatively and quantitatively assessed and correlated with the irradiated volumes as well as neurocognitive function and quality of life of the patients. Using a “radiomics” approach, signatures predicting local control and acute/late toxicity after (chemo)radiotherapy will be developed.

Scientific Goals

  • Predict neurocognitive function and quality of life in primary brain tumor patients undergoing photon- or proton-beam (chemo)radiotherapy.
  • Identify intracranial sub-volumes linked to increased risk of neurocognitive side-effects, and
  • evaluate adequate dose delivery while avoiding these radiation-sensitive sub-volumes in the future.
  • Sustain neurocognitive function and quality of life by employing optimal beam quality and radiation dose distribution.
Figure 1: The state-of-the-art MRI protocols are used in this study and include quantitative MRI, MR Spectroscopy and Diffusion imaging. @Raschke

Figure 1: The state-of-the-art MRI protocols are used in this study and include quantitative MRI, MR Spectroscopy and Diffusion imaging.
Copyright: Raschke

Wijsman R, Dankers F, Troost EGC, Hoffmann AL, van der Heijden EHFM, de Geus-Oei L-F, Bussink J. Incidental radiation dose to the atria and ventricles of the heart and the risk of radiation pneumonitis in advanced stage non-small cell lung cancer patients treated with intensity-modulated radiation therapy. In press in Int J Radiother Oncol Biol Phys.

Zindler JD, Jochems A, Lagerwaard FJ, Breuer R, Troost EGC, Eekers DBP, Compter I, van der Toorn P-P, Essers M, Oei B, Hurkmans C, Bruynzeel AME, Bosmans G, Swinnen A, Leijenaar RTH, Lambin P. Individualized early death and long-term survival prediction after stereotactic radiosurgery for brain metastases of non-small cell lung cancer: two externally validated nomograms. In press in Radiother Oncol.

Dankers F, Wijsman R, Troost EGC, Monshouwer R, Bussink J, Hoffmann AL. Dose-surface maps do not improve the predictive performance of a multivariable NTCP model for acute esophageal toxicity in advanced stage NSCLC patients treated with intensity-modulated (chemo-)radiotherapy. In press in Phys Med Biol.

Apolle R, Rehm M, Bortfeld T, Baumann M, Troost EGC. The Clinical Target Volume in Lung, Head-and-neck, and Esophageal Cancer: Lessons from Pathological Measurement and Recurrence Analysis.  Clinical Translational Radiation Oncology 2017;3:1-8. IF: N.A. [Cited by: N.A.].

Zschaeck S, Simon M, Löck S, Troost EGC, Stützer K, Appold S, Makocki S, Bütof R, Richter C, Baumann M, Krause M. PRONTOX – proton therapy to reduce acute normal tissue toxicity in locally advanced Non-Small-Cell Lung Carcinomas (NSCLC). BioMed Central Trials 17(1), 543. IF: 1.859 [Cited by: N.A.].

Wijsman R, Dankers F, Troost EGC, Hoffmann AL, Van der Heijden E, De Geus-Oei L-F, Bussink J. Comparison of toxicity and outcome in advanced stage non-small lung cancer patients treated with intensity-modulated (chemo-)radiotherapy using IMRT or VMAT. Radiother Oncol 2017;122(2):295-299. IF: 4.709 [Cited by: N.A.].

Martinussen H, Reymen B, Wanders S, Troost EGC, Dingemans AMC, Öllers M, De Ruysscher D, Lambin P, van Baardwijk A. Risk of isolated nodal failure, treatment outcome and toxicity for stage III NSCLC treated with selective nodal irradiation using IMRT. Radiother Oncol 2016;121(2):322-327. IF: 4.709 [Cited by: N.A.].

Wink KCJ, van Baardwijk A, Troost EGC*, De Ruysscher D*. Nodal recurrence after stereotactic body radiotherapy for early stage non-small cell lung cancer: incidence and proposed risk factors. (Shared last authorship) In press in Cancer Treatment Reviews.

Reckziegel D, Raschke F, Cottam WJ, Auer DP. Cingulate GABA levels inversely correlate with the intensity of ongoing chronic knee osteoarthritis pain. Molecular pain 2016;12:1-9 doi: 10.1177/1744806916650690

Eekers DBP , Roelofs E, Jelen U, Kirk M, Granzier M, Ammazzalorso F, Ahn P, Janssens GORJ, Hoebers FJP, Friedmann T, Solberg T, Troost EGC, Kaanders JHAM, Lambin P. Benefit of particle therapy in re-irradiation of Head and Neck patients. Results of a multicenter in silico ROCOCO trial. Radiother Oncol 2016;121(3):387-94.

Raschke F, Howe FA, Barrick TR. Processing imaging data to obtain tissue type information. Oct 2014. WO Patent App. PCT/GB2014/051,305

Raschke F, Fellows G, Wright AJ, Howe FA. 1H 2D MRSI LCModel tissue type analysis of gliomas. Magnetic Resonance in Medicine. 2015;73(4):1381–1389.

Raschke F, Jones TL, Barrick TR, Howe FA. Delineation of gliomas using radial metabolite indexing. NMR in Biomedicine 2014;27(9).

Troost EGC, Thorwarth D, Oyen WJG. Imaging-based treatment adaptation in radiation oncology. J Nucl Med 2015;56(12):1922-1929.

Contact

Prof. Dr. med. Dr. Esther Troost
Institute of Radiooncology, Helmholtz-Zentrum Dresden-Rossendorf,
Department of Radiotherapy and Radiation Oncology,
Medical Faculty and University Hospital Carl Gustav Carus of the Technische Universität Dresden
Phone +49 (0)351 458 2394
esther.troost(at)uniklinikum-dresden.de