Computed tomography versus magnetic resonance imaging-based contouring in cervical cancer brachytherapy:: Results of a prospective trial and preliminary guidelines for standardized contours
Computed tomography versus magnetic resonance imaging-based contouring in cervical cancer brachytherapy:: Results of a prospective trial and preliminary guidelines for standardized contours
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DOI：
10.1016/j.ijrobp.2006.12.021
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发表时间：
2007-06-01
影响因子：
7
通讯作者：
Potter, Richard
中科院分区：
文献类型：
--
作者：
Viswanathan, Akila N.;Dimopoulos, Johannes;Potter, Richard
目的：为了比较的轮廓和剂量体积直方图（DVH）的肿瘤和器官的危险（OAR）与计算机断层扫描（CT）与磁共振成像（MRI）在宫颈癌brachytherapy.Methods和Materials：10例患者进行了MRI和CT后，施加器插入。评价了至少90%体积（D-90）接受的剂量、最小靶剂量（D-100）、高风险（HR）和中等风险（IR）临床靶体积（CTV）的处方剂量或更高剂量治疗体积以及OAR的0.1 cm（3）、1 cm（3）和2 cm（3）剂量。一个标准化的方法来勾画CT（CTStd）的开发，实施（HR-和IR-CTVCTStd），并与MRI continues.Results：肿瘤的高度，厚度和总体积测量，无论是由CT或CTStd确定与MRI卷相比，没有显着不同。相比之下，HR-CTVCTStd（p = 0.05）和IR-CTVCTStd（p = 0.01）的宽度测量值不同。对于HR-CTVCTStd，这导致处方剂量或更高剂量（MRI，96% vs. CTStd，86%，p = 0.01）、D-100（MRI，5.4 vs. CTStd，3.4，p < 0.01）和D-90（MRI，8.7 vs. CTStd，6.7，p < 0.01）的治疗体积存在统计学显著差异。相应地，D-100（MRI，3.0 vs. CTStd，2.2，p = 0.01）和D-90（MRI，5.6 vs. CTStd，4.6，p = 0.02）中MRI vs. CTStd的IR-CTV DVH值不同。MRI和CT DVH值的剂量为0.1 cm（3），1 cm（3），和2 cm（3）的OARs.Conclusion：基于计算机断层扫描或基于MRI的扫描在近距离放射治疗是足够的OAR DVH分析。然而，CT肿瘤轮廓可能会显著高估肿瘤宽度，导致HR-CTV与MRI相比，D90、D100和处方剂量或更大剂量治疗体积存在显著差异。MRI仍然是CTV定义的标准。(C)2007年爱思唯尔公司
Purpose: To compare the contours and dose-volume histograms (DVH) of the tumor and organs at risk (OAR) with computed tomography (CT) vs. magnetic resonance imaging (MRI) in cervical cancer brachytherapy.Methods and Materials: Ten patients underwent both MRI and CT after applicator insertion. The dose received by at least 90% of the volume (D-90), the minimal target dose (D-100), the volume treated to the prescription dose or greater for tumor for the high-risk (HR) and intermediate-risk (IR) clinical target volume (CTV) and the dose to 0.1 cm(3), 1 cm(3), and 2 cm(3) for the OARs were evaluated. A standardized approach to contouring on CT (CTStd) was developed, implemented (HR- and IR-CTVCTStd), and compared with the MRI contours.Results: Tumor height, thickness, and total volume measurements, as determined by either CT or CTStd were not significantly different compared with the MRI volumes. In contrast, the width measurements differed in HR-CTVCTStd (p = 0.05) and IR-CTVCTStd(p = 0.01). For the HR-CTVCTStd, this resulted in statistically significant differences in the volume treated to the prescription dose or greater (MRI, 96% vs. CTStd, 86 %, p = 0.01), D-100 (MRI, 5.4 vs. CTStd, 3.4, p < 0.01), and D-90 (MRI, 8.7 vs. CTStd, 6.7, p < 0.01). Correspondingly, the IR-CTV DVH values on MRI vs. CTStd, differed in the D-100 (MRI, 3.0 vs. CTStd, 2.2, p = 0.01) and D-90 (MRI, 5.6 vs. CTStd, 4.6, p = 0.02). The MRI and CT DVH values of the dose to 0.1 cm(3), 1 cm(3), and 2 cm(3) for the OARs were similar.Conclusion: Computed tomography-based or MRI-based scans at brachytherapy are adequate for OAR DVH analysis. However, CT tumor contours can significantly overestimate the tumor width, resulting in significant differences in the D90, D100, and volume treated to the prescription dose or greater for the HR-CTV compared with that using MRI. MRI remains the standard for CTV definition. (C) 2007 Elsevier Inc.