1. Modality-specific target definition for laryngeal and hypopharyngeal cancer on FDG-PET, CT and MRI.
- Author
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Ligtenberg H, Jager EA, Caldas-Magalhaes J, Schakel T, Pameijer FA, Kasperts N, Willems SM, Terhaard CH, Raaijmakers CP, and Philippens ME
- Subjects
- Aged, Female, Humans, Hypopharyngeal Neoplasms pathology, Hypopharyngeal Neoplasms surgery, Hypopharynx diagnostic imaging, Hypopharynx pathology, Hypopharynx surgery, Imaging, Three-Dimensional methods, Laryngeal Neoplasms pathology, Laryngeal Neoplasms surgery, Laryngectomy, Larynx diagnostic imaging, Larynx pathology, Larynx surgery, Male, Middle Aged, Preoperative Care methods, Radiopharmaceuticals, Fluorodeoxyglucose F18, Hypopharyngeal Neoplasms diagnostic imaging, Laryngeal Neoplasms diagnostic imaging, Magnetic Resonance Imaging methods, Positron-Emission Tomography methods, Tomography, X-Ray Computed methods
- Abstract
Background and Purpose: The goal of this study was to improve target definition by deriving modality-specific margins for clinical target volumes (CTV) for laryngeal and hypopharyngeal cancer on CT, MRI and 18-FDG-PET., Material and Methods: Twenty-five patients with T3/T4 laryngeal/hypopharyngeal cancer underwent CT, MRI and 18-FDG-PET scans before laryngectomy. HE-sections were obtained from the surgical specimen and tumor was delineated (tumor
HE ). The GTVs on CT and MRI were delineated in consensus. PET-based GTVs were automatically segmented. The three-dimensionally reconstructed specimen was registered to the various images. Modality-specific CTV margins were derived and added to the GTVs to achieve adequate tumor coverage. The resulting CTVs were compared with each other, to tumorHE , and to CTVCT10 constructed on CT with the clinical margin of 10mm., Results: CTV margins of 4.3mm (CT), 6.1mm (MRI) and 5.2mm (PET) were needed to achieve adequate tumor coverage. The median volumes of the resulting modality-specific CTVs were 44ml (CT), 48ml (MRI) and 39ml (PET), while the CTV10mm was 80ml., Conclusion: For laryngohypopharyngeal tumors, 45-52% target volume reduction compared with CTV10mm is achievable when modality-specific CTV margins are used. PET-based CTVs were significantly smaller compared to CT- and MRI-based CTVs., (Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.)- Published
- 2017
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