Impact of FDG-PET/CT fused imaging on tumor volume assessment of head-and-neck squamous cell carcinoma: Intermethod and interobserver variations
Impact of FDG-PET/CT fused imaging on tumor volume assessment of head-and-neck squamous cell carcinoma: Intermethod and interobserver variations
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DOI：
10.1080/02841850802027034
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发表时间：
2008-01-01
期刊：
影响因子：
1.3
通讯作者：
Yamashita, Y.
中科院分区：
文献类型：
--
作者：
Murakami, R.;Uozumi, H.;Yamashita, Y.
背景：虽然原发部位的大体肿瘤体积（GTV）可以预测接受器官保留治疗的患者头颈鳞状细胞癌（SCC）的局部控制，但GTV评估并不能消除观察者间的实质性差异。目的：评估F-18-氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）/计算机断层扫描（CT）是否有效 融合成像为 GTV 评估提供了附加信息。材料和方法：我们获得了 20 名头颈部 SCC 患者的 FDG-PET/CT 融合图像。所有患者均接受了术前常规检查，包括增强 CT 和磁共振成像 (MRI)。原发肿瘤的 GTV 由两名独立观察者使用常规临床数据设计。观察员 A 是一名放射科医生，观察员 B 是一名放射肿瘤科医生。 GTV1 和 GTV2 分别在不使用和使用 FDG-PET/CT 的情况下设计。对于观察者间的几何比较，我们将一致性率计算为 GTV 的交集（A 布尔值 AND B）与其并集（A 布尔值 OR B）的比率。通过 Bland-Altman 分析和 Spearman 等级相关检验评估 GTV 的方法间（GTV1 与 GTV2）和观察者间（A 与 B）差异。使用双尾配对样本 t 检验比较 GTV1 和 GTV2 的观察者间一致性率。结果：在 FDG-PET/CT 上，所有原发肿瘤均可见。 GTV1 和 GTV2 之间的体积差异没有系统性趋势。尽管观察者间的 95% 一致性限制比方法间差异更宽，但 GTV2 的观察者间一致性的 95% 限制比 GTV1 更窄。 GTV2 的平均观察者间一致性率高于 GTV1（54.5% vs. 39.1%，P = 0.0002）。 结论：FDG-PET/CT 是一致 GTV 评估的有用方式，不应将其用作单一方式，而应用于获取头颈 SCC 患者的补充信息。
Background: Although gross tumor volume (GTV) at the primary site can predict local control of head-and-neck squamous cell carcinoma (SCC) in patients who are treated with organ-preservation therapy, GTV assessment does not eliminate substantial interobserver variation.Purpose: To evaluate whether F-18-fluorodeoxyglucose positron emission tomography (FDG-PET)/computed tomography (CT) fused imaging provides additional information for GTV assessment.Material and Methods: We obtained FDG-PET/CT fused images on 20 patients with head-and-neck SCC. All had undergone preoperative conventional workup, including contrast-enhanced CT and magnetic resonance imaging (MRI). The GTV of the primary tumors was designed by two independent observers who used routine clinical data. Observer A was a radiologist and observer B a radiation oncologist. GTV1 and GTV2 were designed without and with FDG-PET/CT, respectively. For geometric interobserver comparison, we calculated the concordance rate as the ratio of the intersection (A boolean AND B) of the GTVs to their union (A boolean OR B). Intermethod (GTV1 vs. GTV2) and interobserver (A vs. B) differences in the GTVs were assessed by Bland-Altman analysis and the Spearman rank-correlation test. The interobserver concordance rates for GTV1 and GTV2 were compared using a two-tailed paired-samples t test.Results: On FDG-PET/CT, all primary tumors were visualized. There was no systemic trend for a volume difference between GTV1 and GTV2. Although the 95% limits of agreement were wider for interobserver than intermethod differences, the 95% limits of interobserver agreement were narrower for GTV2 than GTV1. The mean interobserver concordance rate for GTV2 was higher than for GTV1 (54.5% vs. 39.1%, P = 0.0002).Conclusion: FDG-PET/CT is a useful modality for consistent GTV assessment, which should not be used as a single modality but rather to obtain supplemental information in patients with head-and-neck SCC.