Improving the accuracy of target volume delineation by combined use of computed tomography, magnetic resonance imaging and positron emission tomography in head and neck carcinomas

Chauhan, Deepika; Rawat, Sheh; Sharma, Manoj Kumar; Ahlawat, Parveen; Pal, Manoj K.; Gupta, Gopila; Dewan, Abhinav; Gupta, Manoj; Sharma, Shashikant; Dodagoudar, Chandragouda; Pahuja, A.K.; Mitra, Swarupa; Sharma, S. K.

doi:10.4103/0973-1482.163679

Cited by 18 publications

(15 citation statements)

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“…However, the distribution of 18F-FDG is not limited to malignant tissues; thus, PET-CT fusion images can also lead to false negative and false positive results in tumor diagnosis[ 7 ]. False-positive results in PET-CT may occur due to inflammation, limited spatial resolution, and lack of a standard method for segmentation[ 4 ]. However, false-negative results may occur in some slow-growing or low-malignant tumor cells or in necrotic tumor tissues, where glucose metabolism is reduced.…”

Section: Discussionmentioning

confidence: 99%

“…As cancer cells multiply rapidly and metabolize profusely, only radionuclide-containing imaging agents can be used to contrast them. The advantage of MRI is that it has superior soft tissue contrast and fewer dental artifacts, which can clearly distinguish tumors from surrounding soft tissues[ 4 ]. Previous studies[ 5 , 6 ] have shown that it is challenging to delineate GTV based CT images alone; however, an accurate delineation can significantly improve while image fusion occurs between CT and PET or CT and MRI.…”

Section: Introductionmentioning

confidence: 99%

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Positron emission tomography and magnetic resonance imaging combined with computed tomography in tumor volume delineation: A case report

Zhou¹,

Zhao²,

Gao³

2022

WJCC

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BACKGROUND Accurate delineation of the target area for patients with hypopharyngeal cancer is the key to achieving an ideal radiotherapy effect. Since computed tomography (CT) alone can no longer meet the treatment needs, fusing CT images with magnetic resonance imaging (MRI) or positron emission tomography (PET) images can overcome the disadvantages of CT. Herein, we present a clinical case of hypopharyngeal cancer to delineate the tumor volume using combined MRI-CT and PET-CT fusion images to examine if they could accurately cover the tumor volume. CASE SUMMARY A 67-year-old male patient with hypopharyngeal carcinoma could not tolerate chemotherapy and surgery due to complicated health issues such as diabetic nephropathy and other underlying diseases. After multidisciplinary consultations, clinicians eventually agreed to undergo radiotherapy to control the progression of his tumor. He was examined by CT, MRI, and 18-fluorodeoxyglucose-PET for treatment planning, and CT images were fused with PET and MRI images while delineating tumor volume. CONCLUSION The image fusion of MRI-CT and PET-CT has both advantages and disadvantages. Compared with CT images alone, the combination of MRI-CT and PET-CT fusion images can precisely cover the gross tumor volume in hypopharyngeal carcinoma and avoid overestimation or incomplete coverage of tumor volume.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Positron emission tomography and magnetic resonance imaging combined with computed tomography in tumor volume delineation: A case report

Zhou¹,

Zhao²,

Gao³

2022

WJCC

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“…In a dummy run, Felice et al demonstrated the smaller GTV definition and lower inter-observer variability for MRI-based contouring compared to CT-based target volume definition [ 34 ]. Implementation of molecular imaging is a widely investigated field, not only in RT planning of head and neck cancer [ 35 ]. Some trials investigating dose escalation integrate the PET signal by employing different tracers and voxel-based RT-planning [ 5 , 6 , 36 – 39 ].…”

Section: Discussionmentioning

confidence: 99%

Report on planning comparison of VMAT, IMRT and helical tomotherapy for the ESCALOX-trial pre-study

et al. 2020

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Background The ESCALOX trial was designed as a multicenter, randomized prospective dose escalation study for head and neck cancer. Therefore, feasibility of treatment planning via different treatment planning systems (TPS) and radiotherapy (RT) techniques is essential. We hypothesized the comparability of dose distributions for simultaneous integrated boost (SIB) volumes respecting the constraints by different TPS and RT techniques. Methods CT data sets of the first six patients (all male, mean age: 61.3 years) of the pre-study (up to 77 Gy) were used for comparison of IMRT, VMAT, and helical tomotherapy (HT). Oropharynx was the primary tumor location. Normalization of the three step SIB (77 Gy, 70 Gy, 56 Gy) was D95% = 77 Gy. Coverage (CVF), healthy tissue conformity index (HTCI), conformation number (CN), and dose homogeneity (HI) were compared for PTVs and conformation index (COIN) for parotids. Results All RT techniques achieved good coverage. For SIB77Gy, CVF was best for IMRT and VMAT, HT achieved highest CN followed by VMAT and IMRT. HT reached good HTCI value, and HI compared to both other techniques. For SIB70Gy, CVF was best by IMRT. HTCI favored HT, consequently CN as well. HI was slightly better for HT. For SIB56Gy, CVF resulted comparably. Conformity favors VMAT as seen by HTCI and CN. Dmean of ipsilateral and contralateral parotids favor HT. Conclusion Different TPS for dose escalation reliably achieved high plan quality. Despite the very good results of HT planning for coverage, conformity, and homogeneity, the TPS also achieved acceptable results for IMRT and VMAT. Trial registration ClinicalTrials.gov Identifier: NCT 01212354, EudraCT-No.: 2010-021139-15. ARO: ARO 14-01

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“…In a dummy run, Felice et al demonstrated the smaller GTV de nition and lower inter-observer variability for MRI-based contouring compared to CTbased target volume de nition (34). Implementation of molecular imaging is a widely investigated eld, not only in RT planning of head and neck cancer (35). Some trials investigating dose escalation integrate the PET signal by employing different tracers and voxel-based RT-planning (5,6,(36)(37)(38)(39).…”

Section: Discussionmentioning

confidence: 99%

Report on planning comparison of VMAT, IMRT and helical tomotherapy for the ESCALOX-trial pre-study

Pigorsch

Kampfer

Oechsner

et al. 2020

Preprint

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Background: The ESCALOX trial was designed as a multicenter, randomized prospective dose escalation study for head and neck cancer. Therefore, feasibility of treatment planning via different treatment planning systems (TPS) and radiotherapy (RT) techniques is essential. We hypothesized the comparability of dose distributions for simultaneous integrated boost (SIB) volumes respecting the constraints by different TPS and RT techniques. Methods: CT data sets of the first six patients (all male, mean age: 61.3 years) of the pre-study (up to 77 Gy) were used for comparison of IMRT, VMAT, and helical tomotherapy (HT). Oropharynx was the primary tumor location. Normalization of the three step SIB (77 Gy, 70 Gy, 56 Gy) was D95%=77 Gy. Coverage (CVF), healthy tissue conformity index (HTCI), conformation number (CN), and dose homogeneity (HI) were compared for PTVs and conformation index (COIN) for parotids. Results: All RT techniques achieved good coverage. For SIB77Gy, CVF was best for IMRT and VMAT, HT achieved highest CN followed by VMAT and IMRT. HT reached good HTCI value, and HI compared to both other techniques. For SIB70Gy, CVF was best by IMRT. HTCI favored HT, consequently CN as well. HI was slightly better for HT. For SIB56Gy, CVF resulted comparably. Conformity favors VMAT as seen by HTCI and CN. Dmean of ipsilateral and contralateral parotids favor HT. Conclusion: Different TPS for dose escalation reliably achieved high plan quality. Despite the very good results of HT planning for coverage, conformity, and homogeneity, the TPS also achieved acceptable results for IMRT and VMAT. Funding: The ESCALOX trial was supported by the Deutsche Forschungsgemeinschaft (DFG); Grant No.: MO-363/4-1. Trial registration: ClinicalTrials.gov Identifier: NCT 01212354, EudraCT-No.: 2010-021139-15. ARO: ARO 14-01

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Improving the accuracy of target volume delineation by combined use of computed tomography, magnetic resonance imaging and positron emission tomography in head and neck carcinomas

Abstract: PET and MRI are useful imaging tools in head and neck malignancies and should be used in conjunction with CT scan for improved target volume delineation.

Cited by 18 publications

References 0 publications

Positron emission tomography and magnetic resonance imaging combined with computed tomography in tumor volume delineation: A case report

Positron emission tomography and magnetic resonance imaging combined with computed tomography in tumor volume delineation: A case report

Report on planning comparison of VMAT, IMRT and helical tomotherapy for the ESCALOX-trial pre-study

Report on planning comparison of VMAT, IMRT and helical tomotherapy for the ESCALOX-trial pre-study

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