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Radiat Oncol. 2017 Sep 6;12(1):147. doi: 10.1186/s13014-017-0883-z.

Target volume delineation of anal cancer based on magnetic resonance imaging or positron emission tomography.

Author information

1
Department of Physics, University of Oslo, Oslo, Norway. espen.rusten@fys.uio.no.
2
Department of Medical Physics, Oslo University Hospital, Oslo, Norway. espen.rusten@fys.uio.no.
3
Department of Medical Physics, Box 4953 Nydalen, N-0424, Oslo, PO, Norway. espen.rusten@fys.uio.no.
4
Department of Medical Physics, Oslo University Hospital, Oslo, Norway.
5
Department of Oncology, Oslo University Hospital, Oslo, Norway.
6
Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway.
7
Department of Physics, University of Oslo, Oslo, Norway.
8
K.G. Jebsen Colorectal Cancer Research Centre, Oslo University Hospital, Oslo, Norway.

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.

PMID:
28874205
PMCID:
PMC5585969
DOI:
10.1186/s13014-017-0883-z
[Indexed for MEDLINE]
Free PMC Article

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