ArticlePhysics and imaging in radiation oncology2026
Advanced diffusion MRI tractography for radiotherapy planning in pediatric brain tumors: A feasibility study.
Article in Physics and imaging in radiation oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background and purpose: Cranial radiotherapy for pediatric brain tumors can damage white matter tracts (WMTs), adversely impacting brain development. This study evaluated the feasibility of integrating advanced diffusion MRI (dMRI) tractography-derived WMTs into radiotherapy planning for pediatric supratentorial high-grade tumors. Materials and methods: The study retrospectively recruited eight patients (aged 8-16 years) who had undergone surgery and curative-intent radiotherapy from January 2012 to June 2022. The pre-radiotherapy dMRI was utilized to reconstruct the target and 29 individual WMT masks selected based on their relevance to neurocognition, motor, language, and visual functions. These WMT masks were classified into five distance-based priority groups based on their proximity to the tumor, and were subsequently used to re-optimize radiotherapy plans. The dose-volume metrics of the tract-optimized plans were compared to the standard treated plans using the Wilcoxon signed-rank test. Results: In all cases, the tract-optimized plans achieved a significant dose reduction to the normal brain compared with standard plans across various dose levels (D Conclusion: Integrating advanced dMRI tractography into radiotherapy plan can enable functional sparing of critical WMTs without compromising target coverage for pediatric supratentorial high-grade brain tumors.
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