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Figure 1 | Radiation Oncology

Figure 1

From: Integration method of 3D MR spectroscopy into treatment planning system for glioblastoma IMRT dose painting with integrated simultaneous boost

Figure 1

3D-MRSI acquisition before radiation therapy treatment of a 53 year-old unresected patient with confirmed glioblastoma located in the right capsulo-thalamic region (first row, the volume of acquisition is framed in red). On the T1-Gd anatomic MR images showing contrast-enhancing disease, the MRSI volume of interest is defined on a voxel by voxel basis,when alteration of metabolites spectra is observed, the voxel is rejected (green frame on second row). The anatomic-metabolic maps are computed from the above defined volume of interest (third row), the maximum Cho/NAA ratio values are encoded in red color and are respectively from left to right 2.27, 2.30, 1.52 and 1.15. The first two metabolite maps which present ratios of Cho/NAA ≥ 2.00 suggest metabolic tumor activity. Regions of interest corresponding to ratio of Cho/NAA ≥ 2.00 are obtained after normalization and threshold based segmentation from the anatomic-metabolic images, these ROIs are highlighted in red (last row). Note on the first image (last row) that the location of the abnormal spectroscopic region is different and below the contrast-enhancing area.

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