FDG–PET–CT reduces the interobserver variability in rectal tumor delineation

Buijsen, Jeroen; Bogaard, J. van den; Weide, H. L. van der; Engelsman, Stephanie; Stiphout, Ruud van; Janssen, M.; Beets, Geerard L.; Beets‐Tan, Regina G. H.; Lambin, Philippe; Lammering, Guido

doi:10.1016/j.radonc.2011.12.016

Cited by 51 publications

(45 citation statements)

References 51 publications

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“…Breast MRI improved IOV in delineation of tumour bed in one of two studies and GTV in another, but there was no improvement in CTV variability in the three studies which assessed this . The use of registered PET scans reduced IOV in all three lung cancer studies and in all four rectal cancer studies, although this was confined to rectal GTV in two studies . Registered PET scans did not reduce delineation variability for head and neck cancers .…”

Section: Resultsmentioning

confidence: 83%

“…Some studies compared volume delineation on two separate imaging modalities including two different CT scans, CT vs MRI, CT vs cone‐beam CT and MRI scans using different sequences . Other studies compared standard imaging with the use of additional registered data sets such as specialised CT, MRI and PET . This refers to the importation of additional imaging as secondary data sets into the radiotherapy planning system and registration to the simulation CT usually using anatomical bony landmarks.…”

Section: Resultsmentioning

confidence: 99%

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A review of interventions to reduce inter‐observer variability in volume delineation in radiation oncology

et al. 2016

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Section: Resultsmentioning

confidence: 83%

Section: Resultsmentioning

confidence: 99%

A review of interventions to reduce inter‐observer variability in volume delineation in radiation oncology

et al. 2016

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“…Multiple studies have reported the uncertainties and high – intra and inter – observer variability associated with target delineation in lung cancers [4–10]. Efforts have been made to reduce the observer variation for target definition, including standardized delineation protocols on CT scans and the addition of fused FDG-PET-CT information on the delineation process [11–14]. The later has diminished the inter-observer variability [15], however differences among observers are still observed for visual delineations [16].…”

Section: Introductionmentioning

confidence: 99%

A semiautomatic CT-based ensemble segmentation of lung tumors: Comparison with oncologists’ delineations and with the surgical specimen

Velazquez

Aerts

et al. 2012

Radiotherapy and Oncology

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101

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Purpose To assess the clinical relevance of a semiautomatic CT-based ensemble segmentation method, by comparing it to pathology and to CT/PET manual delineations by five independent radiation oncologists in non-small cell lung cancer (NSCLC). Materials and Methods For twenty NSCLC patients (stage Ib – IIIb) the primary tumor was delineated manually on CT/PET scans by five independent radiation oncologists and segmented using a CT based semi-automatic tool. Tumor volume and overlap fractions between manual and semiautomatic-segmented volumes were compared. All measurements were correlated with the maximal diameter on macroscopic examination of the surgical specimen. Imaging data is available on www.cancerdata.org. Results High overlap fractions were observed between the semi-automatically segmented volumes and the intersection (92.5 ± 9.0, mean ± SD) and union (94.2 ± 6.8) of the manual delineations. No statistically significant differences in tumor volume were observed between the semiautomatic segmentation (71.4 ± 83.2 cm3, mean ± SD) and manual delineations (81.9 ± 94.1 cm3; p = 0.57). The maximal tumor diameter of the semiautomatic-segmented tumor correlated strongly with the macroscopic diameter of the primary tumor (r = 0.96). Conclusion Semiautomatic segmentation of the primary tumor on CT demonstrated high agreement with CT/PET manual delineations and strongly correlated with the macroscopic diameter considered the “gold standard”. This method may be used routinely in clinical practice and could be employed as a starting point for treatment planning, target definition in multi-center clinical trials or for high throughput data mining research. This method is particularly suitable for peripherally located tumors.

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“…This contouring process significantly reduces the interobserver variability in the interpretation of images, as it eliminates the human factor, increases consistency, and diminishes interobserver variability [ 42 , 43 ] . Krengli et al [ 44 ] analyzed the interobserver variation for target volume delineation in preoperative radiotherapy of rectal cancer, and concluded that PET/CT may allow a reduced interobserver variation in GTV delineation in comparison with CT. Buijsen et al [ 45 ] analyzed the effect of the use of PET/CT on the interobserver variation in GTV definition in rectal cancer. Forty-two patients diagnosed with rectal cancer underwent PET/CT for radiotherapy planning.…”

Section: Positron Emission Tomographymentioning

confidence: 99%

Clinical application of multimodality imaging in radiotherapy treatment planning for rectal cancer

Wang

Zhe

2013

Cancer Imaging

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Radiotherapy plays an important role in the treatment of rectal cancer. Three-dimensional conformal radiotherapy and intensity-modulated radiotherapy are mainstay techniques of radiotherapy for rectal cancer. However, the success of these techniques is heavily reliant on accurate target delineation and treatment planning. Computed tomography simulation is a cornerstone of rectal cancer radiotherapy, but there are limitations, such as poor soft-tissue contrast between pelvic structures and partial volume effects. Magnetic resonance imaging and positron emission tomography (PET) can overcome these limitations and provide additional information for rectal cancer treatment planning. PET can also reduce the interobserver variation in the definition of rectal tumor volume. However, there is a long way to go before these image modalities are routinely used in the clinical setting. This review summarizes the most promising studies on clinical applications of multimodality imaging in target delineation and treatment planning for rectal cancer radiotherapy.

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FDG–PET–CT reduces the interobserver variability in rectal tumor delineation

Abstract: PET-CT increases the interobserver agreement in the GTV definition in rectal cancer, helps to avoid geographical misses and allows tailoring the caudal border of the treatment volume.

Cited by 51 publications

References 51 publications

A review of interventions to reduce inter‐observer variability in volume delineation in radiation oncology

A review of interventions to reduce inter‐observer variability in volume delineation in radiation oncology

A semiautomatic CT-based ensemble segmentation of lung tumors: Comparison with oncologists’ delineations and with the surgical specimen

Clinical application of multimodality imaging in radiotherapy treatment planning for rectal cancer

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