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<p>In modern Boron neutron capture therapy (BNCT) treatment planning, <sup>18</sup>F-BPA (<sup>18</sup>F-boronophenylalanine) PET (positron emission tomography) imaging is used to assess boron uptake and guide accurate dose delivery. This study evaluates the geometric and dosimetric differences between target volumes defined by MRI (magnetic resonance imaging) and PET images in accelerator-based BNCT using the NeuPex system. The GTV (gross tumor volume) was defined based on MRI (GTV<sub>MRI</sub>) and PET images with SUV thresholds of 2.0 (GTV<sub>PET2.0</sub>) and 2.5 (GTV<sub>PET2.5</sub>) in patients with head-and-neck cancer (HNC) and malignant glioma (MG). GTV<sub>PET2.5</sub> was approximately 50% smaller, while GTV<sub>PET2.0</sub> showed closer volumetric agreement, with ∆V% of 23.52 ± 17.44 (HNC) and 28.71 ± 12.57 (MG), and corresponding Dice similarity coefficients of 0.71 ± 0.14 and 0.86 ± 0.17. Dosimetric analysis revealed that GTV<sub>PET2.0</sub> achieved higher dose coverage than GTV<sub>MRI</sub>, with mean doses of 24.07 ± 6.42&#xa0;Gy-Eq (HNC) and 26.36 ± 9.77&#xa0;Gy-Eq (MG), and D<sub>80</sub> values of 19.01 ± 6.90&#xa0;Gy-Eq and 21.00 ± 7.51&#xa0;Gy-Eq, respectively. Tumor-to-blood ratio (TBR) and tumor-to-normal ratio (TNR) analyses further indicated substantial heterogeneity in boron uptake, with mean TBR and TNR of 2.71 ± 0.53 and 2.97 ± 0.79 for GTV<sub>PET2.0.</sub> These results suggest that GTV<sub>PET2.0</sub> provides a balanced and biologically relevant target for BNCT planning. A TBR threshold of ≥ 2.0 is proposed as a practical criterion for patient selection. While this study focuses on geometric and dosimetric endpoints, future work correlating these findings with clinical outcomes is warranted. Overall, this study supports the integration of functional PET imaging with anatomical MRI to improve the precision and efficacy of BNCT treatment planning.</p>

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MRI and 18F-BPA PET-guided targeting in boron neutron capture therapy

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年8月25日

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  • Cai-Rong Hu,
  • You-Qun Lai,
  • Ye Cao,
  • Jian-Ji Pan,
  • Yuan-Hao Liu,
  • Yi-Chiao Teng,
  • Xiao-Bin Xia

摘要

In modern Boron neutron capture therapy (BNCT) treatment planning, 18F-BPA (18F-boronophenylalanine) PET (positron emission tomography) imaging is used to assess boron uptake and guide accurate dose delivery. This study evaluates the geometric and dosimetric differences between target volumes defined by MRI (magnetic resonance imaging) and PET images in accelerator-based BNCT using the NeuPex system. The GTV (gross tumor volume) was defined based on MRI (GTVMRI) and PET images with SUV thresholds of 2.0 (GTVPET2.0) and 2.5 (GTVPET2.5) in patients with head-and-neck cancer (HNC) and malignant glioma (MG). GTVPET2.5 was approximately 50% smaller, while GTVPET2.0 showed closer volumetric agreement, with ∆V% of 23.52 ± 17.44 (HNC) and 28.71 ± 12.57 (MG), and corresponding Dice similarity coefficients of 0.71 ± 0.14 and 0.86 ± 0.17. Dosimetric analysis revealed that GTVPET2.0 achieved higher dose coverage than GTVMRI, with mean doses of 24.07 ± 6.42 Gy-Eq (HNC) and 26.36 ± 9.77 Gy-Eq (MG), and D80 values of 19.01 ± 6.90 Gy-Eq and 21.00 ± 7.51 Gy-Eq, respectively. Tumor-to-blood ratio (TBR) and tumor-to-normal ratio (TNR) analyses further indicated substantial heterogeneity in boron uptake, with mean TBR and TNR of 2.71 ± 0.53 and 2.97 ± 0.79 for GTVPET2.0. These results suggest that GTVPET2.0 provides a balanced and biologically relevant target for BNCT planning. A TBR threshold of ≥ 2.0 is proposed as a practical criterion for patient selection. While this study focuses on geometric and dosimetric endpoints, future work correlating these findings with clinical outcomes is warranted. Overall, this study supports the integration of functional PET imaging with anatomical MRI to improve the precision and efficacy of BNCT treatment planning.