Interobserver and intermodality variability in GTV delineation on simulation CT, FDG-PET, and MR Images of Head and Neck Cancer.

Jacobs journal of radiation oncology Pub Date : 2014-09-01

Carryn M Anderson, Wenqing Sun, John M Buatti, Joan E Maley, Bruno Policeni, Sarah L Mott, John E Bayouth

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Abstract

Purpose: To compare the interobserver and intermodality differences in image-based identification of head and neck primary site gross tumor volumes (GTV). Modalities compared include: contrast-enhanced CT, F-18 fluorodeoxyglucose positron emission tomography (PET/CT) and contrast-enhanced MRI.

Methods and materials: Fourteen patients were simulated after immobilization for all 3 imaging modalities (CT, PET/CT, MRI). Three radiation oncologists (RO) contoured GTVs as seen on each modality. The GTV was contoured first on the contrast-enhanced CT (considered the standard), then on PET/CT, and finally on post-contrast T1 MRI. Interobserver and intermodality variability were analyzed by volume, intersection, union, and volume overlap ratio (VOR).

Results: Analysis of RO contours revealed the average volume for CT-, PET/CT-, and MRI-derived GTVs were 45cc, 35cc and 49cc, respectively. In 93% of cases PET/CT-derived GTVs had the smallest volume and in 57% of cases MRI-derived GTVs had the largest volume. CT showed the largest variation in target definition (standard deviation amongst observers 35%) compared to PET/CT (28%) and MRI (27%). The VOR was largest (indicating greatest interobserver agreement) in PET/CT (46%), followed by MRI (36%), followed by CT (34%). For each observer, the least agreement in GTV definition occurred between MRI & PET/CT (average VOR = 41%), compared to CT & PET/CT (48%) and CT & MRI (47%).

Conclusions: A nonsignificant interobserver difference in GTVs for each modality was seen. Among three modalities, CT was least consistent, while PET/CT-derived GTVs had the smallest volumes and were most consistent. MRI combined with PET/CT provided the least agreement in GTVs generated. The significance of these differences for head & neck cancer is important to explore as we move to volume-based treatment planning based on multi-modality imaging as a standard method for treatment delivery.

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头颈癌模拟CT、FDG-PET和MR图像上GTV描绘的观察者间和模态间变异性。

目的:比较基于图像识别头颈部原发部位总肿瘤体积(GTV)的观察者间和模式间差异。比较的方式包括:对比增强CT, F-18氟脱氧葡萄糖正电子发射断层扫描(PET/CT)和对比增强MRI。方法与材料:对14例患者进行固定后的CT、PET/CT、MRI 3种影像学模拟。三位放射肿瘤学家(RO)绘制了gtv的轮廓图，如图所示。首先在对比增强CT上(被认为是标准)对GTV进行轮廓，然后在PET/CT上，最后在对比后T1 MRI上。通过体积、交叉、联合和体积重叠比(VOR)分析观察者间和模态间的变异性。结果:RO轮廓分析显示，CT、PET/CT和mri衍生gtv的平均体积分别为45cc、35cc和49cc。在93%的病例中，PET/ ct衍生的gtv体积最小，57%的病例中，mri衍生的gtv体积最大。与PET/CT(28%)和MRI(27%)相比，CT显示出最大的目标定义差异(观察者之间的标准差为35%)。VOR在PET/CT中是最大的(表明观察者之间的一致性最大)(46%)，其次是MRI(36%)，其次是CT(34%)。对于每个观察者来说，与CT和PET/CT(48%)和CT和MRI(47%)相比，MRI和PET/CT之间的GTV定义一致性最低(平均VOR = 41%)。结论:观察者之间gtv的差异不显著。在三种模式中，CT最不一致，而PET/CT衍生的gtv体积最小，最一致。MRI与PET/CT联合产生的gtv一致性最低。当我们转向基于多模态成像的基于体积的治疗计划作为标准治疗方法时，探索这些差异对头颈癌的意义非常重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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