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

Background This study aimed to quantify the variation in oropharyngeal squamous cell carcinoma gross tumour volume (GTV) delineation between CT, MR and FDG PET-CT imaging. Methods A prospective, single centre, pilot study was undertaken where 11 patients with locally advanced oropharyngeal cancers (...

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Bibliographic Details
Published in:BMC cancer Vol. 15; no. 1; p. 844
Main Authors: Bird, David, Scarsbrook, Andrew F., Sykes, Jonathan, Ramasamy, Satiavani, Subesinghe, Manil, Carey, Brendan, Wilson, Daniel J., Roberts, Neil, McDermott, Gary, Karakaya, Ebru, Bayman, Evrim, Sen, Mehmet, Speight, Richard, Prestwich, Robin J.D.
Format: Journal Article
Language:English
Published: London BioMed Central 04.11.2015
BioMed Central Ltd
Springer Nature B.V
Subjects:
Adult
Aged
Biomedical and Life Sciences
Biomedicine
Cancer
Cancer Research
Carcinoma, Squamous Cell - diagnostic imaging
Carcinoma, Squamous Cell - pathology
Care and treatment
Complications and side effects
Consent
Diagnostic imaging
Female
Fluorodeoxyglucose F18 - chemistry
Health aspects
Health Promotion and Disease Prevention
Humans
Magnetic Resonance Imaging - methods
Male
Medicine/Public Health
Middle Aged
Oncology
Oropharyngeal Neoplasms - diagnostic imaging
Oropharyngeal Neoplasms - pathology
Patients
Positron-Emission Tomography - methods
Radiation therapy
Radiotherapy
Research Article
Research ethics
Squamous cell carcinoma
Surgical Oncology
Tomography
Tomography, X-Ray Computed
Tumors
United Kingdom > UK
Positron-emission tomography
Computed tomography
Magnetic resonance imaging
Delineation
Gross tumour volume
Fluorodeoxyglucose F18
Head and neck squamous cell cancer
Radiotherapy
ISSN:1471-2407, 1471-2407
Online Access:Get full text
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Summary:Background This study aimed to quantify the variation in oropharyngeal squamous cell carcinoma gross tumour volume (GTV) delineation between CT, MR and FDG PET-CT imaging. Methods A 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. Results Significant differences in mean GTV volume were found between CT (11.9 cm 3 ) and CT-MR (14.1 cm 3 ), p  < 0.006, CT-MR and PET (9.5 cm 3 ), p  < 0.0009, and MR (12.7 cm 3 ) 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 cm 3 ) and oncologists (14.6 cm 3 ) for all modalities ( p  = 0.001). Conclusions The 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 registration ISRCTN Registry: ISRCTN34165059 . Registered 2nd February 2015.
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ISSN:1471-2407
1471-2407
DOI:10.1186/s12885-015-1867-8