Target delineation in post-operative radiotherapy of brain gliomas: Interobserver variability and impact of image registration of MR (pre-operative) images on treatment planning CT scans
Target delineation in post-operative radiotherapy of brain gliomas: Interobserver variability and impact of image registration of MR (pre-operative) images on treatment planning CT scans
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DOI：
10.1016/j.radonc.2005.03.012
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发表时间：
2005-05-01
影响因子：
5.7
通讯作者：
Calandrino, R
中科院分区：
文献类型：
--
作者：
Cattaneo, GM;Reni, M;Calandrino, R
背景和目的：研究术前MR硬拷贝（CT+MR(conv)）或CT-MR（术前）配准图像（CT+MR（匹配））在CT扫描中颅内肿瘤描绘的观察者间变异性。患者和方法：五位医生概述了7例HGG患者的“初始”临床肿瘤体积（CTVO）和根治性切除后放疗（RT）的候选患者。观察人员使用患者在治疗位置的术后CT图像和术前MR x线片（CT+MR(conv)）进行筛查肿瘤划定；他们还在屏幕上用CT和相应的MR轴向图像（CT+MR（匹配））勾勒出CTVO。定量评价了图像融合的精度。进行了一项分析，以评估五名观察者在CT+MR（conv）和CT+MR（匹配）模式中的变异性。结果：三维空间配准精度始终小于3.7 mm。CT+MR（matched）的一致性指数（47.4 +/- 12.4%）明显优于CT+MR（conv）的一致性指数（14.1 +/- 12.7%）（P < 0.02）。相交体积分别为CT+MR（匹配）和CT+MR（conv）患者平均体积的67 +/- 15%和24 +/- 18% （P < 0.02）。结论：CT和MR注册成像的使用减少了HGG术后照射靶体积描绘的观察者之间的差异；靶体积周围较小的余量可用于界定辐照技术。2005爱思唯尔爱尔兰有限公司版权所有。
Background and purpose: To investigate the interobserver variability of intracranial tumour delineation on computed tomography (CT) scans using pre-operative MR hardcopies (CT+MR(conv)) or CT-MR (pre-operative) registered images (CT+MR(matched)).Patients and methods: Five physicians outlined the 'initial' clinical tumour volume (CTVO) of seven patients affected by HGG and candidates for radiotherapy (RT) after radical resection. The observers performed on screen-tumour delineation using post-operative CT images of the patients in the treatment position and pre-operative MR radiographs (CT+MR(conv)); they also outlined CTVO with both CT and corresponding MR axial image on screen (CT+MR(matched)). The accuracy of the image fusion was quantitatively assessed. An analysis was conducted to assess the variability among the five observers in CT+MR(conv) and CT+MR(matched) modality.Results: The registration accuracy in 3D space is always less than 3.7 mm. The concordance index was significantly better in CT+MR(matched) (47.4 +/- 12.4%) than in CT+MR(conv) (14.1 +/- 12.7%) modality (P < 0.02). The intersecting volumes represent 67 +/- 15 and 24 +/- 18% of the patient mean volume for CT+MR(matched) and CT+MR(conv), respectively (P < 0.02).Conclusions: The use of CT and MR registered imaging reduces interobserver variability in target volume delineation for post-operative irradiation of HGG; smaller margins around target volume could be adopted in defining irradiation technique. (c) 2005 Elsevier Ireland Ltd. All rights reserved.