Observer variation in contouring gross tumor volume in patients with poorly defined non-small-cell lung tumors on CT:: The impact of 18FDG-hybrid PET fusion
Observer variation in contouring gross tumor volume in patients with poorly defined non-small-cell lung tumors on CT:: The impact of 18FDG-hybrid PET fusion
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DOI：
10.1016/s0360-3016(01)01722-9
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发表时间：
2001-11-15
影响因子：
7
通讯作者：
Ehrlich, LE
中科院分区：
文献类型：
--
作者：
Caldwell, CB;Mah, K;Ehrlich, LE
目的：使用 CT 图像对非小细胞肺癌和 CT 上肿瘤边界不清的患者的肿瘤总体积 (GTV) 定位的观察者间差异进行量化，并确定如果将 2-[F-18]氟-2-脱氧-D-葡萄糖 (FDG)-混合正电子发射断层扫描 (PET) 与 CT 图像进行配准，是否会减少变异性。 方法和材料：前瞻性地对30例非小细胞肺癌患者进行放射治疗当天进行CT和FDG-hybrid PET检查。使用八个基准标记对图像进行配准。制定了 GTV 轮廓指南。三名放射肿瘤科医生独立进行定位。变异系数用于评估观察者间的变异性。结果：定义的 GTV 大小在观察者之间显示出很大的差异。对于仅 CT 和 CT/FDG 联合配准数据，最大与最小 GTV 的平均比率分别为 2.31 和 1.56。添加 PET 降低了 30 例中的 23 例的这一比率，并增加了 7 例的比率。基于组合模式的 GTV 的平均变异系数显着小于仅使用 CT 数据的变异系数 (p < 0.01)。结论：基于 CT 的 GTV 定义可能会出现观察者的高度变异性。如果使用配准的 FDG 混合 PET 图像，通常可以获得更一致的 GTV 定义。 (C) 2001 爱思唯尔科学公司。
Purpose: To quantify interobserver variation in gross tumor volume (GTV) localization using CT images for patients with non-small-cell lung carcinoma and poorly defined tumors on CT and to determine whether variability would be reduced if coregistered 2-[F-18]fluoro-2-deoxy-D-glucose (FDG)-hybrid positron emission tomography (PET) with CT images were used.Methods and Materials: Prospectively, 30 patients with non-small-cell lung carcinoma had CT and FDG-hybrid PET examinations in radiation treatment position on the same day. Images were coregistered using eight fiducial markers. Guidelines were established for contouring GTVs. Three radiation oncologists performed localization independently. The coefficient of variation was used to assess interobserver variability.Results: The size of the GTV defined showed great variation among observers. The mean ratios of largest to smallest GTV were 2.31 and 1.56 for CT only and for CT/FDG coregistered data, respectively. The addition of PET reduced this ratio in 23 of 30 cases and increased it in 7. The mean coefficient of variation for GTV based on the combined modalities was significantly smaller (p < 0.01) than that for CT data only.Conclusions: High observer variability in CT-based definition of the GTV can occur. A more consistent definition of the GTV can often be obtained if coregistered FDG-hybrid PET images are used. (C) 2001 Elsevier Science Inc.