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The value of magnetic resonance imaging in target volume delineation of base of tongue tumours - A study using flexible surface coils

Abstract

Introduction: Magnetic resonance imaging (MRI) provides superior diagnostic accuracy over computed tomography (CT) in oropharyngeal tumours. Precise delineation of the gross tumour volume (GTV) is mandatory in radiotherapy planning when a GTV boost is required. CT volume definition in this regard is poor. We studied the feasibility of using flexible surface (flex-L) coils to obtain MR images for MR-CT fusion to assess the benefit of MRI over CT alone in planning base of tongue tumours. Methods: Eight patients underwent CT and MRI radiotherapy planning scans with an immobilisation device. Distortion-corrected T1-weighted post-contrast MR scans were fused to contrast-enhanced planning CT scans. GTV, clinical target and planning target volumes (CTV, PTV) and organs at risk (OAR) were delineated on CT, then on MRI with blinding to the CT images. The volumetric and spatial differences between MRI and CT volumes for GTV, CTV, PTV and OAR were compared. MR image distortions due to field inhomogeneity and non-linear gradients were corrected and the need for such correction was evaluated. Results: The mean primary GTV was larger on MRI (22.2 vs. 9.5 cm{sup 3}, p = 0.05) than CT. The mean primary and nodal GTV (i.e. BOT and macroscopic nodes) was significantly larger on  More>>
Authors:
Ahmed, Merina; [1]  Schmidt, Maria; [2]  Sohaib, Aslam; [3]  Kong, Christine; Burke, Kevin; [1]  Richardson, Cheryl; Usher, Marianne; [2]  Brennan, Sinead; [4]  Riddell, Angela; [3]  Davies, Mark; Newbold, Kate; [1]  Harrington, Kevin J; Nutting, Christopher M; [1]  Institute of Cancer Research, London (United Kingdom)]
  1. Department of Radiotherapy, Royal Marsden NHS Foundation Trust, London (United Kingdom)
  2. Cancer Research UK Clinical Magnetic Resonance Group, Royal Marsden NHS Foundation Trust, Surrey (United Kingdom)
  3. Department of Radiology, Royal Marsden NHS Foundation Trust, London (United Kingdom)
  4. Department of Radiotherapy, St. James's Hospital, Dublin (Ireland)
Publication Date:
Feb 15, 2010
Product Type:
Journal Article
Resource Relation:
Journal Name: Radiotherapy and Oncology; Journal Volume: 94; Journal Issue: 2; Conference: 10. biennial ESTRO conference on physics and radiation technology for clinical radiotherapy, Maastricht (Netherlands), 30 Aug - 3 Sep 2009; Other Information: DOI: 10.1016/j.radonc.2009.12.021; PII: S0167-8140(09)00679-3; Copyright (c) 2009 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CAT SCANNING; NMR IMAGING; PATIENTS; PLANNING; RADIATION DOSES; RADIOTHERAPY; SPINAL CORD; TONGUE; BODY; CENTRAL NERVOUS SYSTEM; COMPUTERIZED TOMOGRAPHY; DIAGNOSTIC TECHNIQUES; DIGESTIVE SYSTEM; DOSES; MEDICINE; NERVOUS SYSTEM; NUCLEAR MEDICINE; ORAL CAVITY; ORGANS; RADIOLOGY; THERAPY; TOMOGRAPHY
OSTI ID:
21343507
Country of Origin:
Ireland
Language:
English
Other Identifying Numbers:
Journal ID: ISSN 0167-8140; RAONDT; TRN: IE10R0104074385
Availability:
Available from http://dx.doi.org/10.1016/j.radonc.2009.12.021
Submitting Site:
INIS
Size:
page(s) 161-167
Announcement Date:
Oct 26, 2010

Citation Formats

Ahmed, Merina, Schmidt, Maria, Sohaib, Aslam, Kong, Christine, Burke, Kevin, Richardson, Cheryl, Usher, Marianne, Brennan, Sinead, Riddell, Angela, Davies, Mark, Newbold, Kate, Harrington, Kevin J, Nutting, Christopher M, and Institute of Cancer Research, London (United Kingdom)]. The value of magnetic resonance imaging in target volume delineation of base of tongue tumours - A study using flexible surface coils. Ireland: N. p., 2010. Web. doi:10.1016/j.radonc.2009.12.021.
Ahmed, Merina, Schmidt, Maria, Sohaib, Aslam, Kong, Christine, Burke, Kevin, Richardson, Cheryl, Usher, Marianne, Brennan, Sinead, Riddell, Angela, Davies, Mark, Newbold, Kate, Harrington, Kevin J, Nutting, Christopher M, & Institute of Cancer Research, London (United Kingdom)]. The value of magnetic resonance imaging in target volume delineation of base of tongue tumours - A study using flexible surface coils. Ireland. doi:10.1016/j.radonc.2009.12.021.
Ahmed, Merina, Schmidt, Maria, Sohaib, Aslam, Kong, Christine, Burke, Kevin, Richardson, Cheryl, Usher, Marianne, Brennan, Sinead, Riddell, Angela, Davies, Mark, Newbold, Kate, Harrington, Kevin J, Nutting, Christopher M, and Institute of Cancer Research, London (United Kingdom)]. 2010. "The value of magnetic resonance imaging in target volume delineation of base of tongue tumours - A study using flexible surface coils." Ireland. doi:10.1016/j.radonc.2009.12.021. https://www.osti.gov/servlets/purl/10.1016/j.radonc.2009.12.021.
@misc{etde_21343507,
title = {The value of magnetic resonance imaging in target volume delineation of base of tongue tumours - A study using flexible surface coils}
author = {Ahmed, Merina, Schmidt, Maria, Sohaib, Aslam, Kong, Christine, Burke, Kevin, Richardson, Cheryl, Usher, Marianne, Brennan, Sinead, Riddell, Angela, Davies, Mark, Newbold, Kate, Harrington, Kevin J, Nutting, Christopher M, and Institute of Cancer Research, London (United Kingdom)]}
abstractNote = {Introduction: Magnetic resonance imaging (MRI) provides superior diagnostic accuracy over computed tomography (CT) in oropharyngeal tumours. Precise delineation of the gross tumour volume (GTV) is mandatory in radiotherapy planning when a GTV boost is required. CT volume definition in this regard is poor. We studied the feasibility of using flexible surface (flex-L) coils to obtain MR images for MR-CT fusion to assess the benefit of MRI over CT alone in planning base of tongue tumours. Methods: Eight patients underwent CT and MRI radiotherapy planning scans with an immobilisation device. Distortion-corrected T1-weighted post-contrast MR scans were fused to contrast-enhanced planning CT scans. GTV, clinical target and planning target volumes (CTV, PTV) and organs at risk (OAR) were delineated on CT, then on MRI with blinding to the CT images. The volumetric and spatial differences between MRI and CT volumes for GTV, CTV, PTV and OAR were compared. MR image distortions due to field inhomogeneity and non-linear gradients were corrected and the need for such correction was evaluated. Results: The mean primary GTV was larger on MRI (22.2 vs. 9.5 cm{sup 3}, p = 0.05) than CT. The mean primary and nodal GTV (i.e. BOT and macroscopic nodes) was significantly larger on MRI (27.2 vs. 14.4 cm{sup 3}, p = 0.05). The volume overlap index (VOI) between MRI and CT for the primary was 0.34 suggesting that MRI depicts parts of the primary tumour not detected by CT. There was no significant difference in volume delineation between MR and CT for CTV, PTV, nodal CTV and nodal PTV. MRI volumes for brainstem and spinal cord were significantly smaller due to improved organ definition (p = 0.002). Susceptibility and gradient-related distortions were not found to be clinically significant. Conclusion: MRI improves the definition of tongue base tumours and neurological structures. The use of MRI is recommended for GTV dose-escalation techniques to provide precise depiction of GTV and improved sparing of spinal cord and brainstem.}
doi = {10.1016/j.radonc.2009.12.021}
journal = {Radiotherapy and Oncology}
issue = {2}
volume = {94}
place = {Ireland}
year = {2010}
month = {Feb}
}