1. Target volume delineation of anal cancer based on magnetic resonance imaging or positron emission tomography
- Author
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Bettina Hanekamp, Eivor Hernes, Christine Undseth, Marianne Grønlie Guren, Eirik Malinen, Espen Rusten, Taran Paulsen Hellebust, Ghazwan Al-Haidari, and B.L. Rekstad
- Subjects
lcsh:Medical physics. Medical radiology. Nuclear medicine ,Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,lcsh:R895-920 ,lcsh:RC254-282 ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Medical imaging ,Anal cancer ,Humans ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Aged ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Research ,Reproducibility of Results ,Magnetic resonance imaging ,Middle Aged ,medicine.disease ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Anus Neoplasms ,Magnetic Resonance Imaging ,Radiation therapy ,Oncology ,Positron emission tomography ,030220 oncology & carcinogenesis ,Positron-Emission Tomography ,Carcinoma, Squamous Cell ,Female ,Radiology ,Tomography ,Nuclear medicine ,business ,Preclinical imaging ,Emission computed tomography - Abstract
Purpose To compare target volume delineation of anal cancer using positron emission tomography (PET) and magnetic resonance imaging (MRI) with respect to inter-observer and inter-modality variability. Methods Nineteen patients with anal cancer undergoing chemoradiotherapy were prospectively included. Planning computed tomography (CT) images were co-registered with 18F–fluorodexocyglucose (FDG) PET/CT images and T2 and diffusion weighted (DW) MR images. Three oncologists delineated the Gross Tumor Volume (GTV) according to national guidelines and the visible tumor tissue (GTVT). MRI and PET based delineations were evaluated by absolute volumes and Dice similarity coefficients. Results The median volume of the GTVs was 27 and 31 cm3 for PET and MRI, respectively, while it was 6 and 11 cm3 for GTVT. Both GTV and GTVT volumes were highly correlated between delineators (r = 0.90 and r = 0.96, respectively). The median Dice similarity coefficient was 0.75 when comparing the GTVs based on PET/CT (GTVPET) with the GTVs based on MRI and CT (GTVMRI). The median Dice coefficient was 0.56 when comparing the visible tumor volume evaluated by PET (GTVT_PET) with the same volume evaluated by MRI (GTVT_MRI). Margins of 1–2 mm in the axial plane and 7–8 mm in superoinferior direction were required for coverage of the individual observer’s GTVs. Conclusions The rather good agreement between PET- and MRI-based GTVs indicates that either modality may be used for standard target delineation of anal cancer. However, larger deviations were found for GTVT, which may impact future tumor boost strategies.
- Published
- 2017