Variability in prostate and seminal vesicle delineations defined on magnetic resonance images, a multi-observer, -center and -sequence study

Radiation Oncology

Björn Zackrisson⁵  Rhona McMenemin⁹  John Frew⁹  Hazel McCallum⁹  Jawaher Ansari⁷  Azmat Sadozye⁷  Scott Hanvey²  Redas Trepiakas⁶  Poul Flemming Geertsen¹  Claus F Behrens¹  Gunilla Frykholm⁸  Andreas Carlberg³  Per Bergström⁵  Karin Söderström⁵  Joakim Jonsson⁴  Tufve Nyholm⁴ 

[1] Department of Oncology, Herlev University Hospital, Herlev, Denmark;Department of Clinical Physics and Bioengineering, Radiotherapy Physics, Beatson West of Scotland Cancer Centre, Glasgow, Scotland, G12 0YN, UK;Department of Medical Physics, Karolinska University Hospital, Solna, Sweden;Department for Radiation Sciences, Radiation Physics, Umeå University, Umeå, Sweden;Department for Radiation Sciences, Oncology, Umeå University, Umeå, Sweden;Department of Oncology, Hillerød Hospital, Hillerød, Denmark;Department of Clinical Oncology, Beatson West of Scotland Cancer Centre, Glasgow, Scotland, G12 0YN, UK;Department of Oncology, Karolinska University Hospital, Solna, Sweden;Northern Centre for Cancer Care, Newcastle-Upon-Tyne Hospitals NHS Trust, High Heaton, Newcastle upon Tyne, UK

关键词: Variability;    Radiotherapy;    Magnetic resonance imaging;    Delineation;    Seminal-vesicles;    Prostate;   

Others  :  1153889
DOI  :  10.1186/1748-717X-8-126

 received in 2012-10-31, accepted in 2013-03-28,  发布年份 2013

【 摘 要 】

Background

The use of magnetic resonance (MR) imaging as a part of preparation for radiotherapy is increasing. For delineation of the prostate several publications have shown decreased delineation variability using MR compared to computed tomography (CT). The purpose of the present work was to investigate the intra- and inter-physician delineation variability for prostate and seminal vesicles, and to investigate the influence of different MR sequence settings used clinically at the five centers participating in the study.

Methods

MR series from five centers, each providing five patients, were used. Two physicians from each center delineated the prostate and the seminal vesicles on each of the 25 image sets. The variability between the delineations was analyzed with respect to overall, intra- and inter-physician variability, and dependence between variability and origin of the MR images, i.e. the MR sequence used to acquire the data.

Results

The intra-physician variability in different directions was between 1.3 - 1.9 mm and 3 – 4 mm for the prostate and seminal vesicles respectively (1 std). The inter-physician variability for different directions were between 0.7 – 1.7 mm and approximately equal for the prostate and seminal vesicles. Large differences in variability were observed for individual patients, and also for individual imaging sequences used at the different centers. There was however no indication of decreased variability with higher field strength.

Conclusion

The overall delineation variability is larger for the seminal vesicles compared to the prostate, due to a larger intra-physician variability. The imaging sequence appears to have a large influence on the variability, even for different variants of the T2-weighted spin-echo based sequences, which were used by all centers in the study.

【 授权许可】

   
2013 Nyholm et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

Figure 4.

Figure 5.

【 参考文献 】

• [1]Bortfeld T: IMRT: a review and preview. Phys Med Biol 2006, 51:R363-R379.
• [2]Chen GTY, Sharp GC, Mori S: A review of image-guided radiotherapy. Radiol Phys Technol 2009, 2:1-12.
• [3]Njeh CF: Tumor delineation: The weakest link in the search for accuracy in radiotherapy. J Med Phys 2008, 33:136-140.
• [4]Rasch C, Steenbakkers R, van Herk M: Target Definition in Prostate, Head, and Neck. Semin Radiat Oncol 2005, 15:136-145.
• [5]Khoo VS, Joon DL: New developments in MRI for target volume delineation in radiotherapy. Br J Radiol 2006, 79 Spec No:S2-S15.
• [6]Karlsson M, Karlsson MG, Nyholm T, Amies C, Zackrisson B: Dedicated magnetic resonance imaging in the radiotherapy clinic. Int J Radiat Oncol Biol Phys 2009, 74:644-651.
• [7]Hanvey S, Glegg M, Foster J: Magnetic resonance imaging for radiotherapy planning of brain cancer patients using immobilization and surface coils. Phys Med Biol 2009, 54:5381-5394.
• [8]McJury M, O’Neill A, Lawson M, McGrath C, Grey A, Page W, O’Sullivan JM: Assessing the image quality of pelvic MR images acquired with a flat couch for radiotherapy treatment planning. Br J Radiol 2011, 84:750-755.
• [9]Fransson A, Andreo P, Pötter R: Aspects of MR Image Distortions in Radiotherapy Treatment Planning. Strahlentherapie 2001, 177:59-73.
• [10]Nyholm T, Nyberg M, Karlsson MG, Karlsson M: Systematisation of spatial uncertainties for comparison between a MR and a CT-based radiotherapy workflow for prostate treatments. Radiat Oncol 2009, 4:54. BioMed Central Full Text
• [11]Ulin K, Urie MM, Cherlow JM: Results of a multi-institutional benchmark test for cranial CT/MR image registration. Int J Radiat Oncol Biol Phys 2010, 77:1584-1589.
• [12]Prabhakar R, Julka PK, Ganesh T, Munshi A, Joshi RC, Rath GK: Feasibility of using MRI alone for 3D radiation treatment planning in brain tumors. Jpn J Clin Oncol 2007, 37:405-411.
• [13]Beavis AW, Gibbs P, Dealey RA, Whitton VJ: Radiotherapy treatment planning of brain tumours using MRI alone. Br J Radiol 1998, 71:544-548.
• [14]Lee YK, Bollet M, Charles-edwards G, Flower MA, Leach MO, Mcnair H, Moore E, Rowbottom C, Webb S: Radiotherapy treatment planning of prostate cancer using magnetic resonance imaging alone. Science 2003, 66:203-216.
• [15]Buhl SK, Duun-Christensen AK, Kristensen BH, Behrens CF: Clinical evaluation of 3D/3D MRI-CBCT automatching on brain tumors for online patient setup verification - A step towards MRI-based treatment planning. Acta Oncol 2010, 49:1085-1091.
• [16]Rasch C, Barillot I, Remeijer P, Touw A, van Herk M, Lebesque JV: Definition of the prostate in CT and MRI: a multi-observer study. Int J Radiat Oncol Biol Phys 1999, 43:57-66.
• [17]Villeirs GM, Van Vaerenbergh K, Vakaet L, Bral S, Claus F, De Neve WJ, Verstraete KL, De Meerleer GO: Interobserver delineation variation using CT versus combined CT + MRI in intensity-modulated radiotherapy for prostate cancer. Strahlenther Onkol 2005, 181:424-430.
• [18]Debois M, Oyen R, Maes F, Verswijvel G, Gatti G, Bosmans H, Feron M, Bellon E, Kutcher G, van Poppel H, Vanuytsel L: The contribution of magnetic resonance imaging to the three-dimensional treatment planning of localized prostate cancer. Int J Radiat Oncol Biol Phys 1999, 45:857-865.
• [19]Wachter S, Wachter-Gerstner N, Bock T, Goldner G, Kovacs G, Fransson A, Pötter R: Interobserver Comparison of CT and MRI-Based Prostate Apex Definition. Strahlenther Onkol 2002, 178:263-268.
• [20]Jonsson JH, Karlsson MG, Karlsson M, Nyholm T: Treatment planning using MRI data: an analysis of the dose calculation accuracy for different treatment regions. Radiat Oncol 2010, 5:62. BioMed Central Full Text
• [21]Lambert J, Greer PB, Menk F, Patterson J, Parker J, Dahl K, Gupta S, Capp A, Wratten C, Tang C, Kumar M, Dowling J, Hauville S, Hughes C, Fisher K, Lau P, Denham JW, Salvado O: MRI-guided prostate radiation therapy planning: Investigation of dosimetric accuracy of MRI-based dose planning. Radiother Oncol 2011, 98:330-334.
• [22]Jonsson JH, Garpebring A, Karlsson MG, Nyholm T: Internal Fiducial Markers and Susceptibility Effects in MRI-Simulation and Measurement of Spatial Accuracy. Int J Radiat Oncol Biol Phys 2012, 82(5):1612-1618.
• [23]Fisher RA: Statistical Methods for Research Workers. Edinburgh: Oliver and Boyd; 1925.
• [24]Khoo ELH, Schick K, Plank AW, Poulsen M, Wong WWG, Middleton M, Martin JM: Prostate Contouring Variation: Can It Be Fixed? Int J Radiat Oncol Biol Phys 2012, 82(5):1923-1929.
• [25]Remeijer P, Rasch C, Lebesque JV, van Herk M: A general methodology for three-dimensional analysis of variation in target volume delineation. Med Phys 1999, 26:931-940.
• [26]Smith WL, Lewis C, Bauman G, Rodrigues G, D’Souza D, Ash R, Ho D, Venkatesan V, Downey D, Fenster A: Prostate volume contouring: a 3D analysis of segmentation using 3DTRUS, CT, and MR. Int J Radiat Oncol Biol Phys 2007, 67:1238-1247.
• [27]Fiorino C, Reni M, Bolognesi A, Cattaneo GM, Calandrino R: Intra- and inter-observer variability in contouring prostate and seminal vesicles: implications for conformal treatment planning. Radiother Oncol 1998, 47:285-292.