Multimodality imaging with CT, MR and FDG-PET for radiotherapy target volume delineation in oropharyngeal squamous cell carcinoma

BMC Cancer

Research Article

Satiavani Ramasamy¹  Evrim Bayman¹  Mehmet Sen¹  Ebru Karakaya¹  Robin J.D. Prestwich¹  Brendan Carey²  Daniel J. Wilson³  Gary McDermott³  Andrew F. Scarsbrook⁴  Manil Subesinghe⁴  Richard Speight⁵  David Bird⁵  Jonathan Sykes⁵  Neil Roberts⁶ 

[1] Department of Clinical Oncology, St. James’ University Hospital, Leeds Teaching Hospitals NHS Trust, Beckett Street, LS9 7TF, Leeds, UK;Department of Clinical Radiology, St. James’ University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK;Department of Medical Physics, St. James’ University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK;Department of Nuclear Medicine, St. James’ University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK;Department of Clinical Radiology, St. James’ University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK;Department of Radiotherapy Physics, St. James’ University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK;Department of Radiotherapy, St. James’ University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK;

关键词: Head and neck squamous cell cancer;    Radiotherapy;    Gross tumour volume;    Delineation;    Computed tomography;    Fluorodeoxyglucose F18;    Positron-emission tomography;    Magnetic resonance imaging;   

DOI  :  10.1186/s12885-015-1867-8

 received in 2015-04-30, accepted in 2015-10-27,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundThis study aimed to quantify the variation in oropharyngeal squamous cell carcinoma gross tumour volume (GTV) delineation between CT, MR and FDG PET-CT imaging.MethodsA prospective, single centre, pilot study was undertaken where 11 patients with locally advanced oropharyngeal cancers (2 tonsil, 9 base of tongue primaries) underwent pre-treatment, contrast enhanced, FDG PET-CT and MR imaging, all performed in a radiotherapy treatment mask. CT, MR and CT-MR GTVs were contoured by 5 clinicians (2 radiologists and 3 radiation oncologists). A semi-automated segmentation algorithm was used to contour PET GTVs. Volume and positional analyses were undertaken, accounting for inter-observer variation, using linear mixed effects models and contour comparison metrics respectively.ResultsSignificant differences in mean GTV volume were found between CT (11.9 cm3) and CT-MR (14.1 cm3), p < 0.006, CT-MR and PET (9.5 cm3), p < 0.0009, and MR (12.7 cm3) and PET, p < 0.016. Substantial differences in GTV position were found between all modalities with the exception of CT-MR and MR GTVs. A mean of 64 %, 74 % and 77 % of the PET GTVs were included within the CT, MR and CT-MR GTVs respectively. A mean of 57 % of the MR GTVs were included within the CT GTV; conversely a mean of 63 % of the CT GTVs were included within the MR GTV. CT inter-observer variability was found to be significantly higher in terms of position and/or volume than both MR and CT-MR (p < 0.05). Significant differences in GTV volume were found between GTV volumes delineated by radiologists (9.7 cm3) and oncologists (14.6 cm3) for all modalities (p = 0.001).ConclusionsThe use of different imaging modalities produced significantly different GTVs, with no single imaging technique encompassing all potential GTV regions. The use of MR reduced inter-observer variability. These data suggest delineation based on multimodality imaging has the potential to improve accuracy of GTV definition.Trial registrationISRCTN Registry: ISRCTN34165059. Registered 2nd February 2015.

【 授权许可】

CC BY   
© Bird et al. 2015