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Title: The utility of multimodality imaging with CT and MRI in defining rectal tumour volumes for radiotherapy treatment planning: a pilot study.
Austin Authors: Tan, J;Lim Joon, Daryl ;Fitt, Gregory J ;Wada, Morikatsu ;Lim Joon, M;Mercuri, A;Marr, M;Chao, M ;Khoo, Vincent
Affiliation: Radiation Oncology
Issue Date: 1-Dec-2010
Publication information: Journal of Medical Imaging and Radiation Oncology; 54(6): 562-8
Abstract: This study compares the volumetric and spatial relationships of gross tumour volume (GTV) derived from CT (CT-GTV) and GTV derived from MRI (MR-GTV) to determine the utility of multi-modality imaging for radiotherapy treatment planning in rectal cancer.Fifteen patients with T3 rectal cancer were accrued over 18 months. The male : female ratio was 2:1. The average age was 60.3 years (range 38-79). All patients underwent a diagnostic MRI and CT and MRI simulation. Data sets were co-registered. A site specialised diagnostic radiologist contoured all volumes in consultation with a radiation oncologist. CT-GTV was contoured while blinded to MR data sets. MR-GTV was contoured independently 2-4 weeks later whilst blinded to its respective CT-GTV data. Tumour volumes were analysed for three anatomical subregions (sigmoid, rectal and anal). Reference points on tumour volumes were used for spatial comparison and analysis.The mean CT-GTV/MR-GTV ratio was 1.2 (range 0.5-2.9). The tumour volume ratios for the rectal subregion were well correlated. CT-GTV provided adequate spatial coverage of tumour in reference to MR-GTV with the average mean discrepancy of 0.12 (range -0.08-0.38) or a maximum discrepancy of <0.4 cm (1.54 standard deviation). CT-GTV coverage was inadequate for tumours with MRI evidence of anal and sigmoid invasion.Conventional simulation CT imaging provided a reasonable estimate of the GTV. Multi-modality imaging with staging MRI can assist target volume definition where there is involvement of the sigmoid and anorectal region and avoid geographic misses. The role of a simulation MRI may aid in this process but remains investigational.
DOI: 10.1111/j.1754-9485.2010.02212.x
Journal: Journal of Medical Imaging and Radiation Oncology
Type: Journal Article
Subjects: Adult
Contrast Media.diagnostic use
Image Enhancement.methods
Magnetic Resonance Imaging.methods
Middle Aged
Pilot Projects
Prospective Studies
Radiotherapy Planning, Computer-Assisted.methods
Radiotherapy, Conformal.methods
Rectal Neoplasms.pathology.radiography
Tomography, X-Ray Computed.methods
Tumor Burden
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