Target volume delineation in breast conserving radiotherapy: are co-registered CT and MR images of added value?
نویسندگان
چکیده
INTRODUCTION In breast conserving radiotherapy differences of target volume delineations between observers do occur. We evaluated whether delineations based on co-registered computed tomography (CT) and magnetic resonance (MR) imaging may result in an improved consistency between observers. We used the delineation conformity index (CI) to compare clinical target volumes of glandular breast tissue (CTV breast) and lumpectomy cavity (LC) on both imaging modalities. METHODS AND MATERIALS Four observers delineated CTV breast and LC on co-registered CTMR images in ten breast cancer patients. CIs were determined for CT and CTMR. Furthermore, the Cavity Visualization Score (CVS) of LC was taken into account. RESULTS The mean CI for CTV breast (CICT;CTV: 0.82 and CICT-CTMR;CTV: 0.80) and LC (CICT;LC: 0.52 and CICT-CTMR;LC: 0.48) did not differ significantly (p=0.07 and p=0.33, respectively). Taking CVS into account for the LC, with a CVS ≥ 4 the mean CI was 0.62 for both CICT;LC and CICT-CTMR;LC. CONCLUSION The mean volume of the delineated glandular breast tissue based on CT was significantly larger compared to the volume based on CTMR. For patients with a CVS ≥ 4, the mean CIs of the LC were higher compared to CVS<4 for volumes delineated on both CT as well as CTMR images. In our study cohort no significant differences between the CIs of the CTV breast and the LC delineated on CTMR co-registered images were found compared to the CIs on CT images only. Adding MR images does not seem to improve consistency of the delineation of the CTV breast and the LC, even though the volumes were copied from CT images. Since we included only ten patients, caution should be taken with regard to the results of our study.
منابع مشابه
Optimization of clinical target volume delineation using magnetic resonance spectroscopic imaging (MRSI) in 3D conformal radiotherapy of prostate cancer
Background: For the purpose of individual clinical target volume assessment in radiotherapy of prostate cancer, MRSI was used as a molecular imaging modality with MRI and CT images. Materials and Methods: The images of 20 prostate cancer patients were used in this study. The MR and MRSI images were registered with CT ones using non-rigid registration technique. The CT based planning (BP), CT/MR...
متن کاملMRI and CT imaging for preoperative target volume delineation in breast-conserving therapy
BACKGROUND Accurate tumor bed delineation after breast-conserving surgery is important. However, consistency among observers on standard postoperative radiotherapy planning CT is low and volumes can be large due to seroma formation. A preoperative delineation of the tumor might be more consistent. Therefore, the purpose of this study was to determine the consistency of preoperative target volum...
متن کاملGenerating Synthetic Computed Tomography and Synthetic Magnetic Resonance (sMR: sT1w/sT2w) Images of the Brain Using Atlas-Based Method
Introduction: Nowadays, magnetic resonance imaging (MRI) in combination with computed-tomography (CT) is increasingly being used in radiation therapy planning. MR and CT images are applied to determine the target volume and calculate dose distribution, respectively. Since the use of these two imaging modalities causes registration uncertainty and increases department w...
متن کاملGenerating the synthetic CT (sCT) and synthetic MR (sMR: sT1w/sT2w) images of the brain using atlas based method
Introduction: Radiation therapy planning (RTP) is one of the clinical applications in which both CT scan and MRI are used. MR and CT images are applied to determine the target volume and calculation of dose distribution, respectively. In addition, using two imaging modalities increases the department workload and cost. In this study, an algorithm was presented to create synthet...
متن کاملGTV delineation in supraglottic laryngeal carcinoma: interobserver agreement of CT versus CT-MR delineation
BACKGROUND GTV delineation is the first crucial step in radiotherapy and requires high accuracy, especially with the growing use of highly conformal and adaptive radiotherapy techniques. If GTV delineations of observers concord, they are considered to be of high accuracy. The aim of the study is to determine the interobserver agreement for GTV delineations of supraglottic laryngeal carcinoma on...
متن کامل