PMC8627340_01
MRI images on preoperative, 3 months postoperative, 1 year postoperative, and current period. (a, b) (08.12.2017) Preoperative MRI reveals a lesion 12 x 10 mm in diameter, hypointense in both T1-w and T2-w, heterogeneously contrast enhancing with gadolinium. (c, d) (06.03.2018) Postoperative MRI reveals a paracentral mass located in the posterior edge of the spinal canal with minimal contrast enhancement. (e, f) (19.01.2019) Control MRI reveals. (g, h) (18.02.2021): MRI at current presentation reveals a lesion which is moderately hypointense in T1-w and hypointense in T2-w with homogeneous contrast enhancement.
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MRI revealed a spinal lesion 12 x 10 mm in diameter at the level of second thoracic vertebra (T2) (Figures 1(a) and 1(b)). MRI was performed 45 days after the surgery, and it was consistent with a remnant paracentral mass (Figures 1(c) and 1(d)). Control MRI a year after showed regression of the lesion (Figures 1(e) and 1(f)). A repeat contrasted thin-slice MRI of cervical and thoracic spine was performed (Figures 1(g) and 1(h)).
Pathology slides. (a) Hematoxylin and eosin staining of z200 magnification reveals spindloid nuclei and thin vascular structures. (b) Diffuse staining with CD34 at x200 magnification. (c) 1-2% proliferation index with Ki-67 at x200 magnification.
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Pathology report confirmed a WHO 2016 Grade 1 solitary fibrous tumor positive for CD34 and negative for S100, epithelial membrane antigen (EMA), and p53 (Figure 2).
Plan summations and dose volume histogram (DVH) of 3DCRT, IMRT, and ARC. (a) Plan summations on axial (upper left), frontal (lower left), and sagittal (lower right) views and DVH graph (upper right) of conformal three-dimensional plan. Outer red line of plan summations represents 50% (25.2 Gy) isodose line, green line represents 42.84 Gy, and blue line represents 50.4 Gy. Red dots represent maximum point doses on each view. (b) Plan summations on axial (upper left), frontal (lower left), and sagittal (lower right) views and DVH graph (upper right) of intensity-modulated radiation therapy plan. Outer red line of plan summations represents 50% (25.2 Gy) isodose line, green line represents 42.84 Gy, and blue line represents 50.4 Gy. Red dots represent maximum point doses on each view. (c) Plan summations on axial (upper left), frontal (lower left), and sagittal (lower right) views and DVH graph (upper right) of volumetric modulated arc therapy plan. Outer red line of plan summations represents 50% (25.2 Gy) isodose line, green line represents 42.84 Gy, and blue line represents 50.4 Gy. Red dots represent maximum point doses on each view.
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Tissue Effects in the Clinic (QUANTEC) model to avoid any radiation-related side effect, namely, myelopathy. Treatment planning was done with conformal three-dimensional (3D), intensity-modified radiation therapy (IMRT), and volumetric modulated arc therapy (VMAT, hereinafter referred to as ARC) approach, respectively (Figure 3).