Investigating the potential of diffusion tensor atlases to generate anisotropic clinical tumor volumes in glioblastoma patients

Kim Hochreuter; Gregory Buti; Ali Ajdari; Christopher P. Bridge; Gregory C. Sharp; Sune Jespersen; Slávka Lukacova; Thomas Bortfeld; Jesper F. Kallehauge

doi:10.1016/j.phro.2024.100688

Investigating the potential of diffusion tensor atlases to generate anisotropic clinical tumor volumes in glioblastoma patients

Kim Hochreuter, Gregory Buti, Ali Ajdari, Christopher P. Bridge, Gregory C. Sharp, Sune Jespersen, Slávka Lukacova, Thomas Bortfeld, Jesper F. Kallehauge^*

^*Corresponding author for this work

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

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Abstract

Background and purpose: Diffusion tensor imaging (DTI) has been proposed to guide the anisotropic expansion from gross tumor volume to clinical target volume (CTV), aiming to integrate known tumor spread patterns into the CTV. This study investigate the potential of using a DTI atlas as an alternative to patient-specific DTI for generating anisotropic CTVs. Materials and Methods: The dataset consisted of twenty-eight newly diagnosed glioblastoma patients from a Danish national DTI protocol with post-operative T1-contrast and DTI imaging. Three different DTI atlases, spatially aligned to the patient images using deformable image registration, were considered as alternatives. Anisotropic CTVs were constructed to match the volume of a 15 mm isotropic expansion by generating 3D distance maps using either patient- or atlas-DTI as input to the shortest path solver. The degree of CTV anisotropy was controlled by the migration ratio, modeling tumor cell migration along the dominant white matter fiber direction extracted from DTI. The similarity between patient- and atlas-DTI CTVs was analyzed using the Dice Similarity Coefficient (DSC), with significance testing according to a Wilcoxon test. Results: The median (range) DSC between anisotropic CTVs generated using patient-specific and atlas-based DTI was 0.96 (0.93–0.97), 0.96 (0.93–0.97), and 0.95 (0.93–0.97) for the three atlases, respectively (p > 0.01), for a migration ratio of 10. The results remained consistent over the range of studied migration ratios (2 to 100). Conclusion: The high degree of similarity between all anisotropic CTVs indicates that atlas-DTI is a viable replacement for patient-specific DTI for incorporating fiber direction into the CTV.

Original language	English
Article number	100688
Journal	Physics and Imaging in Radiation Oncology
Volume	33
ISSN	2405-6316
DOIs	https://doi.org/10.1016/j.phro.2024.100688
Publication status	Published - Jan 2025

Keywords

Anisotropic margin expansion
CTV
DTI
Glioblastoma
Radiotherapy

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10.1016/j.phro.2024.100688

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Hochreuter, K., Buti, G., Ajdari, A., Bridge, C. P., Sharp, G. C., Jespersen, S., Lukacova, S., Bortfeld, T., & Kallehauge, J. F. (2025). Investigating the potential of diffusion tensor atlases to generate anisotropic clinical tumor volumes in glioblastoma patients. Physics and Imaging in Radiation Oncology, 33, Article 100688. https://doi.org/10.1016/j.phro.2024.100688

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title = "Investigating the potential of diffusion tensor atlases to generate anisotropic clinical tumor volumes in glioblastoma patients",

abstract = "Background and purpose: Diffusion tensor imaging (DTI) has been proposed to guide the anisotropic expansion from gross tumor volume to clinical target volume (CTV), aiming to integrate known tumor spread patterns into the CTV. This study investigate the potential of using a DTI atlas as an alternative to patient-specific DTI for generating anisotropic CTVs. Materials and Methods: The dataset consisted of twenty-eight newly diagnosed glioblastoma patients from a Danish national DTI protocol with post-operative T1-contrast and DTI imaging. Three different DTI atlases, spatially aligned to the patient images using deformable image registration, were considered as alternatives. Anisotropic CTVs were constructed to match the volume of a 15 mm isotropic expansion by generating 3D distance maps using either patient- or atlas-DTI as input to the shortest path solver. The degree of CTV anisotropy was controlled by the migration ratio, modeling tumor cell migration along the dominant white matter fiber direction extracted from DTI. The similarity between patient- and atlas-DTI CTVs was analyzed using the Dice Similarity Coefficient (DSC), with significance testing according to a Wilcoxon test. Results: The median (range) DSC between anisotropic CTVs generated using patient-specific and atlas-based DTI was 0.96 (0.93–0.97), 0.96 (0.93–0.97), and 0.95 (0.93–0.97) for the three atlases, respectively (p > 0.01), for a migration ratio of 10. The results remained consistent over the range of studied migration ratios (2 to 100). Conclusion: The high degree of similarity between all anisotropic CTVs indicates that atlas-DTI is a viable replacement for patient-specific DTI for incorporating fiber direction into the CTV.",

keywords = "Anisotropic margin expansion, CTV, DTI, Glioblastoma, Radiotherapy",

author = "Kim Hochreuter and Gregory Buti and Ali Ajdari and Bridge, {Christopher P.} and Sharp, {Gregory C.} and Sune Jespersen and Sl{\'a}vka Lukacova and Thomas Bortfeld and Kallehauge, {Jesper F.}",

note = "Publisher Copyright: {\textcopyright} 2024 The Authors",

year = "2025",

month = jan,

doi = "10.1016/j.phro.2024.100688",

language = "English",

volume = "33",

journal = "Physics and Imaging in Radiation Oncology",

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Investigating the potential of diffusion tensor atlases to generate anisotropic clinical tumor volumes in glioblastoma patients. / Hochreuter, Kim; Buti, Gregory; Ajdari, Ali et al.
In: Physics and Imaging in Radiation Oncology, Vol. 33, 100688, 01.2025.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Investigating the potential of diffusion tensor atlases to generate anisotropic clinical tumor volumes in glioblastoma patients

AU - Hochreuter, Kim

AU - Buti, Gregory

AU - Ajdari, Ali

AU - Bridge, Christopher P.

AU - Sharp, Gregory C.

AU - Jespersen, Sune

AU - Lukacova, Slávka

AU - Bortfeld, Thomas

AU - Kallehauge, Jesper F.

PY - 2025/1

Y1 - 2025/1

N2 - Background and purpose: Diffusion tensor imaging (DTI) has been proposed to guide the anisotropic expansion from gross tumor volume to clinical target volume (CTV), aiming to integrate known tumor spread patterns into the CTV. This study investigate the potential of using a DTI atlas as an alternative to patient-specific DTI for generating anisotropic CTVs. Materials and Methods: The dataset consisted of twenty-eight newly diagnosed glioblastoma patients from a Danish national DTI protocol with post-operative T1-contrast and DTI imaging. Three different DTI atlases, spatially aligned to the patient images using deformable image registration, were considered as alternatives. Anisotropic CTVs were constructed to match the volume of a 15 mm isotropic expansion by generating 3D distance maps using either patient- or atlas-DTI as input to the shortest path solver. The degree of CTV anisotropy was controlled by the migration ratio, modeling tumor cell migration along the dominant white matter fiber direction extracted from DTI. The similarity between patient- and atlas-DTI CTVs was analyzed using the Dice Similarity Coefficient (DSC), with significance testing according to a Wilcoxon test. Results: The median (range) DSC between anisotropic CTVs generated using patient-specific and atlas-based DTI was 0.96 (0.93–0.97), 0.96 (0.93–0.97), and 0.95 (0.93–0.97) for the three atlases, respectively (p > 0.01), for a migration ratio of 10. The results remained consistent over the range of studied migration ratios (2 to 100). Conclusion: The high degree of similarity between all anisotropic CTVs indicates that atlas-DTI is a viable replacement for patient-specific DTI for incorporating fiber direction into the CTV.

AB - Background and purpose: Diffusion tensor imaging (DTI) has been proposed to guide the anisotropic expansion from gross tumor volume to clinical target volume (CTV), aiming to integrate known tumor spread patterns into the CTV. This study investigate the potential of using a DTI atlas as an alternative to patient-specific DTI for generating anisotropic CTVs. Materials and Methods: The dataset consisted of twenty-eight newly diagnosed glioblastoma patients from a Danish national DTI protocol with post-operative T1-contrast and DTI imaging. Three different DTI atlases, spatially aligned to the patient images using deformable image registration, were considered as alternatives. Anisotropic CTVs were constructed to match the volume of a 15 mm isotropic expansion by generating 3D distance maps using either patient- or atlas-DTI as input to the shortest path solver. The degree of CTV anisotropy was controlled by the migration ratio, modeling tumor cell migration along the dominant white matter fiber direction extracted from DTI. The similarity between patient- and atlas-DTI CTVs was analyzed using the Dice Similarity Coefficient (DSC), with significance testing according to a Wilcoxon test. Results: The median (range) DSC between anisotropic CTVs generated using patient-specific and atlas-based DTI was 0.96 (0.93–0.97), 0.96 (0.93–0.97), and 0.95 (0.93–0.97) for the three atlases, respectively (p > 0.01), for a migration ratio of 10. The results remained consistent over the range of studied migration ratios (2 to 100). Conclusion: The high degree of similarity between all anisotropic CTVs indicates that atlas-DTI is a viable replacement for patient-specific DTI for incorporating fiber direction into the CTV.

KW - Anisotropic margin expansion

KW - CTV

KW - DTI

KW - Glioblastoma

KW - Radiotherapy

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U2 - 10.1016/j.phro.2024.100688

DO - 10.1016/j.phro.2024.100688

M3 - Journal article

C2 - 39866246

AN - SCOPUS:85213825216

SN - 2405-6316

VL - 33

JO - Physics and Imaging in Radiation Oncology

JF - Physics and Imaging in Radiation Oncology

M1 - 100688

ER -

Investigating the potential of diffusion tensor atlases to generate anisotropic clinical tumor volumes in glioblastoma patients

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