{"doi":"10.3390/tomography9030086","title":"Applying a Radiation Therapy Volume Analysis Pipeline to Determine the Utility of Spectroscopic MRI-Guided Adaptive Radiation Therapy for Glioblastoma","abstract":"Accurate radiation therapy (RT) targeting is crucial for glioblastoma treatment but may be challenging using clinical imaging alone due to the infiltrative nature of glioblastomas. Precise targeting by whole-brain spectroscopic MRI, which maps tumor metabolites including choline (Cho) and N-acetylaspartate (NAA), can quantify early treatment-induced molecular changes that other traditional modalities cannot measure. We developed a pipeline to determine how spectroscopic MRI changes during early RT are associated with patient outcomes to provide insight into the utility of adaptive RT planning. Data were obtained from a study (NCT03137888) where glioblastoma patients received high-dose RT guided by the pre-RT Cho/NAA twice normal (Cho/NAA ≥ 2x) volume, and received spectroscopic MRI scans pre- and mid-RT. Overlap statistics between pre- and mid-RT scans were used to quantify metabolic activity changes after two weeks of RT. Log-rank tests were used to quantify the relationship between imaging metrics and patient overall and progression-free survival (OS/PFS). Patients with lower Jaccard/Dice coefficients had longer PFS (p = 0.045 for both), and patients with lower Jaccard/Dice coefficients had higher OS trending towards significance (p = 0.060 for both). Cho/NAA ≥ 2x volumes changed significantly during early RT, putting healthy tissue at risk of irradiation, and warranting further study into using adaptive RT planning.","journal":"Tomography","year":2023,"id":386237,"datarank":0.10397207708399181,"base_score":0.6931471805599453,"endowment":0.6931471805599453,"self_citation_contribution":0.10397207708399181,"citation_network_contribution":0.0,"self_endowment_contribution":0.10397207708399181,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9485,"is_data_producer":true,"deposit_databanks":{"ClinicalTrials.gov":["NCT03137888"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1154846,"name":"Su Hyun Kim","orcid":null,"position":1,"is_corresponding":false},{"id":810789,"name":"Karthik K. Ramesh","orcid":null,"position":2,"is_corresponding":false},{"id":1146007,"name":"Alexander S. Giuffrida","orcid":"0000-0001-6512-0992","position":3,"is_corresponding":false},{"id":428905,"name":"Brent D. Weinberg","orcid":"0000-0002-7992-1747","position":4,"is_corresponding":false},{"id":318014,"name":"Eric A. Mellon","orcid":"0000-0001-9892-8402","position":5,"is_corresponding":false},{"id":250706,"name":"Lawrence Kleinberg","orcid":"0000-0003-2473-2305","position":6,"is_corresponding":false},{"id":256332,"name":"Peter B. Barker","orcid":"0000-0002-6410-7793","position":7,"is_corresponding":false},{"id":604766,"name":"Hui Han","orcid":"0000-0002-8890-4295","position":8,"is_corresponding":false},{"id":294153,"name":"Hui‐Kuo G. Shu","orcid":"0000-0002-4060-0874","position":9,"is_corresponding":false},{"id":375815,"name":"Hyunsuk Shim","orcid":"0000-0001-8313-2612","position":10,"is_corresponding":false},{"id":626629,"name":"Eduard Schreibmann","orcid":null,"position":11,"is_corresponding":false},{"id":1071580,"name":"Anuradha G. Trivedi","orcid":"0000-0002-3348-4529","position":0,"is_corresponding":true}],"reference_count":39,"raw_metadata":null,"created_at":"2026-07-19T01:17:56.803401Z","pmid":"37218946","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}