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Comparison of gross target volumes based on four-dimensional CT, positron emission tomography-computed tomography and magnetic resonance imaging in thoracic esophageal cancer
Li Huimin1, Li Jianbin2, Li Fengxiang2, Zhu Youzhe3, Zhang Yingjie2, Guo Yanluan4, Xu Min2, Shao Qian2, Liu Xijun2
1Weifang Medical University, Weifang 261053, China; 2Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250117, China; 3School of Medicine and Life Sciences, University of Jinan, Shandong Academy of Medical Sciences, Jinan 250022, China; 4Department of PET-CT, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250117, China
AbstractObjective To investigate the application value of 18F-FDG PET-CT combined with MRI in the radiotherapy for esophageal carcinoma by comparing the differences in the gross target volume (GTV), position length delineated on the end expiratory (EE) phase of 4DCT, PET-CT and T2-weighted MRI (T2W-MRI). Methods Twenty-six patients with thoracic esophageal cancer scheduled to receive concurrent chemoradiotherapy sequentially underwent 3DCT, 4DCT,PET-CT and enhanced MRI for thoracic localization. All images were fused with the 3DCT images by deformable registration. GTVCT, GTV50% GTVPET2.5, GTVMRI and GTVDWI were delineated on 3DCT, the EE phase of 4DCT images, PET-CT with the thresholds of SUV≥2.5, T2W-MRI and diffusion-weighted images, respectively. Results GTVPET2.5 was significantly larger than GTV50% and GTVMRI (P<0.001 and P=0.008),whereas the volume of GTVMRI was similar to that of GTV50%(P=0.439). Significant differences were observed between the CI of GTVMRI to GTV50% and GTVPET2.5 to GTV50%(P=0.004). The conformity indexes (CIs) of GTVMRI to GTVCT and GTVPET2.5 to GTVCT were statistically significant (P=0.004 and P=0.039). The CI of GTVMRI to GTVPET2.5 was significantly smaller than that of GTVMRI to GTV50%, GTVMRI to GTVCT, GTVPET2.5 to GTV50% and GTVPET2.5 to GTVCT (P=0.000-0.021). The length of gastroscopy was similar to those of GTVPET2.5 and GTVDWI (both P>0.05), and there was no significant difference in the length between GTVPET2.5 and GTVDWI (P=0.072). Conclusion GTVMRI yields significantly different volume and poor spatial matching compared with GTVPET2.5. The application of PET-CT combined with MRI under respiratory gating system in the delineation of GTV should be used with caution in thoracic squamous esophageal cancer. MRI-DWI can replace PET-CT to help determine the upper and lower boundaries of GTV based on CT images.
Fund:National Key Research Program of China (2016YFC0904700);Surface Project of National Natural Science Foundation of China (81773287);Key Research Program of Shandong Provence (2016GSF201093);Natural Science Foundation of Shandong Provence (ZR2019PH115)
Corresponding Authors:
Li Jianbin, Email:lijianbin@msn.com;Li Fengxiang, Email:lifengxiangli@aliyun.com
Cite this article:
Li Huimin,Li Jianbin,Li Fengxiang et al. Comparison of gross target volumes based on four-dimensional CT, positron emission tomography-computed tomography and magnetic resonance imaging in thoracic esophageal cancer[J]. Chinese Journal of Radiation Oncology, 2020, 29(7): 508-512.
Li Huimin,Li Jianbin,Li Fengxiang et al. Comparison of gross target volumes based on four-dimensional CT, positron emission tomography-computed tomography and magnetic resonance imaging in thoracic esophageal cancer[J]. Chinese Journal of Radiation Oncology, 2020, 29(7): 508-512.
[1] Nowee ME, Voncken FEM, Kotte ANTJ, et al. Gross tumour delineation on computed tomography and positron emission tomography-computed tomography in oesophageal cancer:a nationwide study[J]. Clin Trans Radiat Oncol, 2018, 14(10):33-39. DOI:10.1016/j.ctro.2018.10.003. [2] Vollenbrock SE, Nowee ME, Voncken FEM, et al. Gross tumor delineation in esophageal cancer on MRI compared with F-FDG-PET/CT[J]. Adv Radiat oncol, 2019, 4(4):596-604. DOI:10.1016/j.adro.2019.04.004. [3] 郭延娈, 李建彬, 李奉祥, 等. 基于PET-CT的SUV值与基于4DCT的EE时相勾画胸段食管癌GTV相关性分析[J]. 中华放射肿瘤学杂志, 2015, 24(2):121-125. DOI:10.3760/cma.j.issn.1004-4221.2015.02.005. [4] Hof H, Rhern B, Haering P, et al. 4D-CT-based target volume definition in stereotactic radiotherapy of lung tumours:comparison with a conventional technique using individual margins[J]. Radiother Oncol, 2009, 93(3):419-423. DOI:10.1016/j.radonc.2009.08.040. [5] Vali FS, Nagda S, Hall W, et al. Comparison of standardized uptake value-based positron emission tomography and computed tomography target volumes in esophageal cancer patients undergoing radiotherapy[J]. Im J Radiat Oncol Biol Phys, 2010, 78(4):1057-1063. DOI:10. 1016/j.ijrobp.2009.09.022. [6] Partovi S, Kohan A, Rubbert C, et al. Clinical oncologic applications of PET/MRI:a new horizon[J]. Am J Nucl Med Mol Imag, 2014, 4(2):202-212. [7] Grills IS, Yan D, Black QC, et al. Clinical implications of defining the gross tumor volume with combination of CT and 18FDG-positron emission tomography in non-small-cell lung cancer[J]. Int J Radiat Oncol Biol Phys, 2007, 67(3):709-719. DOI:10.1016/j.ijrobp.2006.09.046. [8] Guo Y, Li J, Zhang P. A comparative study of target volumes based on (18) F-FDG PET-CT and ten phases of 4DCT for primary thoracic squamous esophageal cancer[J]. Onco Targets Ther, 2017, 10(1):177-184. DOI:10.2147/OTT. S95322. [9] Karki K, Saraiya S, Hugo GD, et al. Variabilities of magnetic resonance imaging-, computed tomography-, and positron emission tomography-computed tomography-based tumor and lymph node delineations for lung cancer radiation therapy planning[J]. Int J Radiat Oncol Niol Phys, 2017, 99(1):80-89. DOI:10.1016/j.ijrobp.2017.05.002. [10] Lee G, I H, Kim SJ, et al. Clinical implication of PET/MR imaging in preoperative esophageal cancer staging:comparison with PET/CT, endoscopic ultrasonography, and CT[J]. J Nucl Med, 2014, 55(8):1242-1247. DOI:10.2967/jnumed.114.138974. [11] Wang Z, Guo J, Qin J, et al. Accuracy of 3-T MRI for preoperative T staging of esophageal cancer after neoadjuvant chemotherapy, with histopathologic correlation[J]. AJR Am J Roentgenol, 2019, 212(4):788-795. DOI:10.2214/AJR.18.20204. [12] 王军, 祝淑钗, 韩春, 等. CT扫描食管造影和内镜测量食管癌病变长度的价值[J]. 中国肿瘤临床, 2008, 35(17):967-970. DOI:10.3969/j.issn.1000-8179.2008.17.002.