Gradient-based delineation of the primary GTV on FLT PET in squamous cell cancer of the thoracic esophagus and impact on radiotherapy planning

Radiation Oncology

Yong Yin²  Jingwei Zhou¹  Jian Zhu²  Tonghai Liu²  Tao Sun²  Jie Lu²  Changsheng Ma²  Dali Han³  Guifang Zhang² 

[1] Department of Radiology, Shandong Cancer Hospital and Institute, Jinan 250117, Shandong Province, P. R. China;Department of Radiation Physics, Shandong Cancer Hospital and Institute, Shandong’s Key Laboratory of Radiation Oncology, Jiyan Road 440, Jinan 250117, Shandong Province, P. R. China;Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong’s Key Laboratory of Radiation Oncology, Jinan, China

关键词: GTV delineation;    FLT-PET;    Radiotherapy;    Esophageal carcinoma;   

Others  :  1150149
DOI  :  10.1186/s13014-014-0304-5

 received in 2013-12-20, accepted in 2014-12-15,  发布年份 2015

【 摘 要 】

Background

To validate a gradient-based segmentation method for gross tumor volume(GTV) delineation on ⁸F-fluorothymidine (FLT)positron emission tomography (PET)/ computer tomography (CT) in esophageal squamous cell cancer through pathologic specimen, in comparison with standardized uptake values (SUV) threshold-based methods and CT. The corresponding impact of this GTV delineation method on treatment planning was evaluated.

Methods and materials

Ten patients with esophageal squamous cell cancer were enrolled. Before radical surgery, all patients underwent FLT-PET/CT. GTVs were delineated by using four methods. GTV_GRAD, GTV_1.4 and GTV_30%max were segmented on FLT PET using a gradient-based method, a fixed threshold of 1.4 SUV and 30% of SUV_max, respectively. GTV_CT was based on CT data alone. The maximum longitudinal tumor length of each segmented GTV was compared with the measured tumor length of the pathologic gross tumor length (L_Path). GTV_GRAD, GTV_1.4 and GTV_30%max were compared with GTV_CT by overlap index. Two radiotherapy plannings (plan_GRAD) and (plan_CT) were designed for each patient based on GTV_GRAD and GTV_CT. The dose-volume parameters for target volume and normal tissues, CI and HI of plan_GRAD and plan_CT were compared.

Results

The mean ± standard deviation of L_Path was 6.47 ± 2.70 cm. The mean ± standard deviation of L_GRAD,L_1.4, L_30%max and L_CT were 6.22 ± 2.61, 6.23 ± 2.80, 5.95 ± 2.50,7.17 ± 2.28 cm, respectively. The Pearson correlation coefficients between L_Path and each segmentation method were 0.989, 0.920, 0.920 and 0.862, respectively. The overlap indices of GTV_GRAD, GTV_1.4, GTV_30%max when compared with GTV_CT were 0.75 ± 0.12, 0.71 ± 0.12, 0.57 ± 0.10, respectively. The V₅, V₁₀, V₂₀, V₃₀ and mean dose of total-lung,V₃₀ and mean dose of heart of plan_GRAD were significantly lower than plan_CT.

Conclusions

The gradient-based method provided the closest estimation of target length. The radiotherapy plannings based on the gradient-based segmentation method reduced the irradiated volume of lung, heart in comparison to CT.

【 授权许可】

   
2015 Zhang et al.; licensee BioMed Central.

【 图 表 】

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