SU-F-J-93: Automated Segmentation of High-Resolution 3D WholeBrain Spectroscopic MRI for Glioblastoma Treatment Planning

Authors


Abstract

Purpose:

We report on an automated segmentation algorithm for defining radiation therapy target volumes using spectroscopic MR images (sMRI) acquired at nominal voxel resolution of 100 microliters.

Methods:

Wholebrain sMRI combining 3D echo-planar spectroscopic imaging, generalized auto-calibrating partially-parallel acquisitions, and elliptical k-space encoding were conducted on 3T MRI scanner with 32-channel head coil array creating images. Metabolite maps generated include choline (Cho), creatine (Cr), and N-acetylaspartate (NAA), as well as Cho/NAA, Cho/Cr, and NAA/Cr ratio maps. Automated segmentation was achieved by concomitantly considering sMRI metabolite maps with standard contrast enhancing (CE) imaging in a pipeline that first uses the water signal for skull stripping. Subsequently, an initial blob of tumor region is identified by searching for regions of FLAIR abnormalities that also display reduced NAA activity using a mean ratio correlation and morphological filters. These regions are used as starting point for a geodesic level-set refinement that adapts the initial blob to the fine details specific to each metabolite.

Results:

Accuracy of the segmentation model was tested on a cohort of 12 patients that had sMRI datasets acquired pre, mid and post-treatment, providing a broad range of enhancement patterns. Compared to classical imaging, where heterogeneity in the tumor appearance and shape across posed a greater challenge to the algorithm, sMRI's regions of abnormal activity were easily detected in the sMRI metabolite maps when combining the detail available in the standard imaging with the local enhancement produced by the metabolites. Results can be imported in the treatment planning, leading in general increase in the target volumes (GTV60) when using sMRI+CE MRI compared to the standard CE MRI alone.

Conclusion:

Integration of automated segmentation of sMRI metabolite maps into planning is feasible and will likely streamline acceptance of this new acquisition modality in clinical practice.

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