Variability of gross tumor volume delineation in head-and-neck cancer using CT and PET/CT fusion

Journal Article · Sat Jul 01 04:00:00 EDT 2006 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2006.01.014· OSTI ID:20842902

Riegel, Adam C ^[1]; Berson, Anthony M ^[2]; Destian, Sylvie ^[3]; Ng, Tracy ^[1]; Tena, Lawrence B ^[1]; Mitnick, Robin J ^[3]; Wong, Ping S ^[1]

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1. Department of Radiation Oncology, St. Vincent's Comprehensive Cancer Center, New York, NY (United States)
2. Department of Radiation Oncology, St. Vincent's Comprehensive Cancer Center, New York, NY, United States and New York Medical College, Westchester, NY (United States)
3. New York Medical College, Westchester, NY (United States)

Purpose: To assess the need for gross tumor volume (GTV) delineation protocols in head-and-neck cancer (HNC) treatment planning by use of positron emission tomography (PET)/computed tomography (CT) fusion imaging. Assessment will consist of interobserver and intermodality variation analysis. Methods and Materials: Sixteen HNC patients were accrued for the study. Four physicians (2 neuroradiologists and 2 radiation oncologists) contoured GTV on 16 patients. Physicians were asked to contour GTV on the basis of the CT alone, and then on PET/CT fusion. Statistical analysis included analysis of variance for interobserver variability and Student's paired sample t test for intermodality and interdisciplinary variability. A Boolean pairwise analysis was included to measure degree of overlap. Results: Near-significant variation occurred across physicians' CT volumes (p = 0.09) and significant variation occurred across physicians' PET/CT volumes (p = 0.0002). The Boolean comparison correlates with statistical findings. One radiation oncologist's PET/CT fusion volumes were significantly larger than his CT volumes (p < 0.01). Conversely, the other radiation oncologist's CT volumes tended to be larger than his fusion volumes (p = 0.06). No significant interdisciplinary variation was seen. Significant disagreement occurred between radiation oncologists. Conclusion: Significant differences in GTV delineation were found between multiple observers contouring on PET/CT fusion. The need for delineation protocol has been confirmed.

• OSTI ID: 20842902
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 3 Vol. 65; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
COMPUTERIZED TOMOGRAPHY
HEAD
MEDICAL PERSONNEL
NECK
NEOPLASMS
PATIENTS
POSITRON COMPUTED TOMOGRAPHY