Comparison of Computed Tomography- and Magnetic Resonance Imaging-based Clinical Target Volume Contours at Brachytherapy for Cervical Cancer.
In: International journal of radiation oncology, biology, physics, Jg. 96 (2016-11-15), Heft 4, S. 793-800
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Zugriff:
Purpose: We prospectively compared computed tomography (CT)- and magnetic resonance imaging (MRI)-based high-risk clinical target volume (HR-CTV) contours at the time of brachytherapy for cervical cancer in an effort to identify patients who might benefit most from MRI-based planning.
Methods and Materials: Thirty-seven patients who had undergone a pretreatment diagnostic MRI scan were included in the analysis. We delineated the HR-CTV on the brachytherapy CT and brachytherapy MRI scans independently for each patient. We then calculated the absolute volumes for each HR-CTV and the Dice coefficient of similarity (DC, a measure of spatial agreement) for the HR-CTV contours. We identified the clinical and tumor factors associated with (1) a discrepancy in volume between the CT HR-CTV and MRI HR-CTV contours; and (2) DC. The mean values were compared using 1-way analysis of variance or paired or unpaired t tests, as appropriate. Simple and multivariable linear regression analyses were used to model the effects of covariates on the outcomes.
Results: Patients with International Federation of Gynecology and Obstetrics stage IB to IVA cervical cancer were treated with intracavitary brachytherapy using tandem and ovoid (n=33) or tandem and cylinder (n=4) applicators. The mean CT HR-CTV volume (44.1 cm 3 ) was larger than the mean MRI HR-CTV volume (35.1 cm 3 ; P<.0001, paired t test). On multivariable analysis, a higher body mass index (BMI) and tumor size ≥5 cm with parametrial invasion on the MRI scan at diagnosis were associated with an increased discrepancy in volume between the HR-CTV contours (P<.02 for both). In addition, the spatial agreement (as measured by DC) between the HR-CTV contours decreased with an increasing BMI (P=.013).
Conclusions: We recommend MRI-based brachytherapy planning for patients with tumors >5 cm and parametrial invasion on MRI at diagnosis and for those with a high BMI.
(Copyright © 2016. Published by Elsevier Inc.)
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Comparison of Computed Tomography- and Magnetic Resonance Imaging-based Clinical Target Volume Contours at Brachytherapy for Cervical Cancer.
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Autor/in / Beteiligte Person: | Swanick, CW ; Castle, KO ; Vedam, S ; Munsell, MF ; Turner, LM ; Rauch, GM ; Jhingran, A ; Eifel, PJ ; Klopp, AH |
Zeitschrift: | International journal of radiation oncology, biology, physics, Jg. 96 (2016-11-15), Heft 4, S. 793-800 |
Veröffentlichung: | New York, NY : Elsevier, Inc ; <i>Original Publication</i>: Elmsford, N. Y., Pergamon Press., 2016 |
Medientyp: | academicJournal |
ISSN: | 1879-355X (electronic) |
DOI: | 10.1016/j.ijrobp.2016.07.035 |
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