Determination of tumour regression rates during radiotherapy for cervical carcinoma by serial MRI: comparison of two measurement techniques and examination of intraobserver and interobserver variability.
Determination of tumour regression rates during radiotherapy for cervical carcinoma by serial MRI: comparison of two measurement techniques and examination of intraobserver and interobserver variability.
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通过连续 MRI 确定宫颈癌放射治疗期间的肿瘤消退率：两种测量技术的比较以及观察者内和观察者间变异性的检查。
DOI：
10.1259/bjr.72.853.10341691
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发表时间：
1999
期刊：
影响因子：
--
通讯作者：
Neil Roberts
中科院分区：
文献类型：
--
作者：
Qiyong Gong;LT Tan;CS Romaniuk;B. Jones;Jnh Brunt;Neil Roberts
使用连续 MRI（平均时间间隔 7 天；范围 3-15 天）评估 11 名宫颈癌患者在外照射放射治疗 (EBRT) 期间的肿瘤消退率。每个受试者平均进行五次调查（范围 4-8）。肿瘤体积由两名观察者使用现代设计体视学的 Cavalieri 方法结合 (a) 面积测量法和 (b) 点计数来测量。通过手动追踪肿瘤轮廓获得的所有体积估计的平均精度为 6.6%。通过对同一样带每次调查平均计算 176 个点获得的平均精度为 6.7%。面积测量的观察者内重复性、面积测量和点计数的观察者间再现性均非常出色，使用任一技术获得的体积估计值之间没有显着差异。根据面积测量，初始肿瘤体积范围为 6.5 至 222 cm3（平均 63 cm3，中位数 44 cm3）。根据点计数测量，初始肿瘤体积范围为 7.2 至 235 cm3（平均 68 cm3，中位数 46 cm3）。肿瘤消退在开始 EBRT 后几天内开始，并与时间呈指数关系 (p < 0.01)。通过面积测量法获得的回归率与通过点计数获得的回归率之间有很好的一致性。对于平面测量或点计数，初始肿瘤体积和肿瘤消退率之间没有发现显着相关性。平均而言，获得面积测量所需的时间大约是点计数所需时间的一半（即分别为 30 分钟和 50 分钟）。虽然点计数通常可能是更有效的方法，但当有专用轨迹球且肿瘤形态相对简单时，面积测定法可能是估计肿瘤体积的首选方法。应使用卡瓦列里方法获得体积测量，以确保估计值无偏且可以预测其精度。测量的肿瘤消退率可能对改善局部肿瘤控制、近距离放射治疗的最佳时机和最大限度地降低辐射损伤的风险具有重要意义。
Tumour regression rates of 11 patients with cervical carcinoma were estimated during external beam radiotherapy (EBRT) using serial MRI (average time interval 7 days; range 3-15 days). An average of five investigations (range 4-8) was performed per subject. Tumour volume was measured by two observers using the Cavalieri method of modern design stereology in combination with (a) planimetry and (b) point counting. The mean precision of all the volume estimates obtained by manually tracing the outline of the tumour was 6.6%. The mean precision obtained by counting an average of 176 points per investigation on the same transects was 6.7%. The intraobserver repeatability of planimetry, interobserver reproducibility of planimetry and point counting were excellent with no significant difference between the volume estimates obtained using either technique. Based on the planimetry measurements, initial tumour volumes ranged from 6.5 to 222 cm3 (mean 63 cm3, median 44 cm3). Based on the point counting measurements, initial tumour volumes ranged from 7.2 to 235 cm3 (mean 68 cm3, median 46 cm3). Tumour regression began within a few days of commencing EBRT and showed an exponential relationship with time (p < 0.01). There was good agreement between the regression rates obtained by planimetry and those obtained by point counting. No significant correlation was found between initial tumour volume and tumour regression rate for either planimetry or point counting. Planimetry measurements were, on average, obtained in about half the time taken for point counting (i.e. 30 min and 50 min, respectively). Although point counting is generally likely to be the more efficient approach, planimetry may be the preferred approach for estimating tumour volume when a purpose built track ball is available and the tumour morphology is relatively simple. Volume measurement should be obtained using the Cavalieri method to ensure that the estimates are unbiased and that their precision can be predicted. The measured tumour regression rates may have important implications for improving local tumour control, optimum timing of brachytherapy and minimizing the risk of radiation damage.
影响因子：
3.1
作者：
WITHERS, HR;TAYLOR, JMG;MACIEJEWSKI, B
通讯作者：
MACIEJEWSKI, B