RT Journal Article
SR Electronic
T1 CT versus MR Imaging in Estimating Cochlear Radiation Dose during Gamma Knife Surgery for Vestibular Schwannomas
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1907
OP 1911
DO 10.3174/ajnr.A5808
VO 39
IS 10
A1 A.M. Faramand
A1 H. Kano
A1 S. Johnson
A1 A. Niranjan
A1 J.C. Flickinger
A1 L.D. Lunsford
YR 2018
UL http://www.ajnr.org/content/39/10/1907.abstract
AB BACKGROUND AND PURPOSE: Leksell stereotactic radiosurgery is an effective option for patients with vestibular schwannomas. Some centers use a combination of stereotactic CT fused with stereotactic MR imaging to achieve an optimal target definition as well as minimize the radiation dose delivered to adjacent structures that correlate with hearing outcomes. The present prospective study was designed to determine whether there is cochlear dose variability between MR imaging and CT.MATERIALS AND METHODS: Fifty consecutive patients underwent stereotactic radiosurgery for vestibular schwannomas. Dose-planning was performed using high-definition fused stereotactic MR imaging and stereotactic CT images. The 3D cochlear volume was determined by delineating the cochlea on both CT and T2-weighted MR imaging. The mean radiation dose, maximum dose, and 3- and 4.20-Gy cochlear volumes were identified using standard Leksell Gamma Knife software.RESULTS: The median mean radiation dose delivered to the cochlea was 3.50 Gy (range, 1.20–6.80 Gy) on CT and 3.40 Gy (range, 1–6.70 Gy) on MR imaging (concordance correlation coefficient = 0.86, r2 = 0.9, P ≤ .001). The median maximum dose delivered to the cochlea was 6.7 Gy on CT and 6.6 Gy on MR imaging (concordance correlation coefficient = 0.89, r2 = 0.90, P ≤ .001). Dose-volume histograms generated from CT and MR imaging demonstrated a strong level of correlation in estimating the 3- and 4.20-Gy volumes (concordance correlation coefficient = 0.81, r2 = 0.82, P ≤ .001 and concordance correlation coefficient = 0.87, r2 = 0.89, P ≤ .001).CONCLUSIONS: Both MR imaging and CT provide similar cochlear dose parameters. Despite the reported superiority of CT in identifying bony structures, high-definition MR imaging alone is sufficient to identify the radiation doses delivered to the cochlea.CCCconcordance correlation coefficientSRSstereotactic radiosurgeryVSvestibular schwannomas