Modality-specific target definition for laryngeal and hypopharyngeal cancer on FDG-PET, CT and MRI

Ligtenberg, H.; Jager, E.A.; Caldas-Magalhaes, J.; Schäkel, T.; Pameijer, Frank A.; Kasperts, N.; Willems, Stefan M.; Terhaard, Chris H.J.; Raaijmakers, Cornelis P.J.; Philippens, M.E.P.

doi:10.1016/j.radonc.2017.02.005

Cited by 58 publications

(58 citation statements)

References 26 publications

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“…When using DWI images, most observers found that there were indistinct boundaries at the edges of the delineation volumes. All observers felt a 5 mm expansion margin to CTV was appropriate which corresponds to the recommendations from the literature . Overall, observers found the DWI dataset useful or would consider its use in 50% of cases.…”

Section: Discussionsupporting

confidence: 63%

“…All observers felt a 5 mm expansion margin to CTV was appropriate which corresponds to the recommendations from the literature. 2 Overall, observers found the DWI dataset useful or would consider its use in 50% of cases. These 50% of cases were all oropharynx-based tumours (such as tonsillar tumours) as opposed to nasopharynx-based tumours.…”

Section: Discussionmentioning

confidence: 98%

“…Furthermore, imaging modalities such as PET can have excellent contrast but low spatial resolution which can also impact GTV delineation . Having slightly larger GTV volumes with DWI may not be an issue as it is thought that current clinically used GTVs for primary HN tumours created by radiation oncologists may already be an overestimation of the actual GTV . On the other hand, it could be inferred that DWI adds uncertainty and therefore radiation oncologists contour larger volumes and this would increase the statistical likelihood of the volumes being incorrect.…”

Section: Discussionmentioning

confidence: 99%

“…23 Having slightly larger GTV volumes with DWI may not be an issue as it is thought that current clinically used GTVs for primary HN tumours created by radiation oncologists may already be an overestimation of the actual GTV. 2,24 On the other hand, it could be inferred that DWI adds uncertainty and therefore radiation oncologists contour larger volumes and this would increase the statistical likelihood of the volumes being incorrect. It is also known that lymphoid tissue can in fact demonstrate restricted diffusion due to their high cellularity.…”

Section: Discussionmentioning

confidence: 99%

“…Determining both accurate and precise gross tumour volumes (GTVs) for radiotherapy is of crucial importance and is often a source of error. 1 Ligtenberg et al 2 recently showed that using CT and T2-weighted (T2W) magnetic resonance imaging (MRI) to generate GTVs in the head and neck (HN) region can result in significant differences between observers. MRI has gained significant popularity in contouring the GTV and organs at risk (OAR) in radiation therapy treatment planning.…”

Section: Introductionmentioning

confidence: 99%

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Evaluating diffusion‐weighted magnetic resonance imaging for target volume delineation in head and neck radiotherapy

et al. 2019

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Introduction Inter‐observer variability (IOV) in target volume delineation is a source of error in head and neck radiotherapy. Diffusion‐weighted imaging (DWI) has been shown to be useful in detecting recurrent head and neck cancer. This study aims to determine whether DWI improves target volume delineation and IOV. Methods Four radiation oncologists delineated the gross tumour volume (GTV) for ten head and neck cancer patients. Delineation was performed on CT alone as well as fused image sets which incorporated fluorodeoxyglucose (FDG)‐positron emission tomography (PET) and magnetic resonance imaging (MRI) in the form of CT/PET, CT/PET/T2W and CT/PET/T2W/DWI image sets. Analysis of the variability of contour volumes was completed by comparison to the simultaneous truth and performance level estimation (STAPLE) volumes. The DICE Similarity Coefficient (DSC) and other IOV metrics for each observer's contour were compared to the STAPLE for each patient and image dataset. A DWI usability scoresheet for delineation was completed. Results The CT/PET/T2W/DWI mean GTV volume of 13.37 (10.35–16.39)cm3 was shown to be different to the mean GTV of 10.92 (8.32–13.51)cm3 when using CT alone (P < 0.001). The GTV DSC amongst observers for CT alone was 0.72 (0.65–0.79), CT/PET was 0.73 (0.67–0.80), CT/PET/T2W was 0.71 (0.64–0.77) and CT/PET/T2W/DWI was 0.69 (0.61–0.75). Conclusion Mean GTVs with the addition of DWI had slightly larger volumes compared to standard CT and CT/PET volumes. DWI may add supplemental visual information for GTV delineation while having a small impact on IOV, therefore potentially improving target volume delineation.

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Section: Discussionsupporting

confidence: 63%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Evaluating diffusion‐weighted magnetic resonance imaging for target volume delineation in head and neck radiotherapy

et al. 2019

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Prognostic imaging variables for recurrent laryngeal and hypopharyngeal carcinoma treated with primary chemoradiotherapy: A systematic review and meta‐analysis

et al. 2021

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Background In this systematic review, we aim to identify prognostic imaging variables of recurrent laryngeal or hypopharyngeal carcinoma after chemoradiotherapy. Methods A systematic search was performed in PubMed and EMBASE (1990–2020). The crude data and effect estimates were extracted for each imaging variable. The level of evidence of each variable was assessed and pooled risk ratios (RRs) were calculated. Results Twenty‐two articles were included in this review, 17 on computed tomography (CT) and 5 on magnetic resonance imaging (MRI) variables. We found strong evidence for the prognostic value of tumor volume at various cut‐off points (pooled RRs ranging from 2.09 to 3.03). Anterior commissure involvement (pooled RR 2.19), posterior commissure involvement (pooled RR 2.44), subglottic extension (pooled RR 2.25), and arytenoid cartilage extension (pooled RR 2.10) were also strong prognostic factors. Conclusion Pretreatment tumor volume and involvement of several subsites are prognostic factors for recurrent laryngeal or hypopharyngeal carcinoma after chemoradiotherapy.

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Improvement of image quality of laryngeal squamous cell carcinoma using noise‐optimized virtual monoenergetic image and nonlinear blending image algorithms in dual‐energy computed tomography

Liu

et al. 2021

Head & Neck

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Background Dual‐energy computed tomography (DECT) has been used to improve image quality of head and neck squamous cell carcinoma (SCC). This study aimed to assess image quality of laryngeal SCC using linear blending image (LBI), nonlinear blending image (NBI), and noise‐optimized virtual monoenergetic image (VMI+) algorithms. Methods Thirty‐four patients with laryngeal SCC were retrospectively enrolled between June 2019 and December 2020. DECT images were reconstructed using LBI (80 kV and M_0.6), NBI, and VMI+ (40 and 55 keV) algorithms. Contrast‐to‐noise ratio (CNR), tumor delineation, and overall image quality were assessed and compared. Results VMI+ (40 keV) had the highest CNR and provided better tumor delineation than VMI+ (55 keV), LBI, and NBI, while NBI provided better overall image quality than VMI+ and LBI (all corrected p < 0.05). Conclusions VMI+ (40 keV) and NBI improve image quality of laryngeal SCC and may be preferable in DECT examination.

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Modality-specific target definition for laryngeal and hypopharyngeal cancer on FDG-PET, CT and MRI

Abstract: For laryngohypopharyngeal tumors, 45-52% target volume reduction compared with CTV is achievable when modality-specific CTV margins are used. PET-based CTVs were significantly smaller compared to CT- and MRI-based CTVs.

Cited by 58 publications

References 26 publications

Evaluating diffusion‐weighted magnetic resonance imaging for target volume delineation in head and neck radiotherapy

Evaluating diffusion‐weighted magnetic resonance imaging for target volume delineation in head and neck radiotherapy

Prognostic imaging variables for recurrent laryngeal and hypopharyngeal carcinoma treated with primary chemoradiotherapy: A systematic review and meta‐analysis

Improvement of image quality of laryngeal squamous cell carcinoma using noise‐optimized virtual monoenergetic image and nonlinear blending image algorithms in dual‐energy computed tomography

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