MRI and CT imaging for preoperative target volume delineation in breast-conserving therapy

被引：51

作者：

den Hartogh, Mariska D. ^{[1
]}

Philippens, Marielle E. P. ^{[1
]}

van Dam, Iris E. ^{[1
]}

Kleynen, Catharina E. ^{[1
]}

Tersteeg, Robbert J. H. A. ^{[1
]}

Pijnappel, Ruud M. ^{[2
]}

Kotte, Alexis N. T. J. ^{[1
]}

Verkooijen, Helena M. ^{[1
,2
]}

van den Bosch, Maurice A. A. J. ^{[2
]}

van Vulpen, Marco ^{[1
]}

van Asselen, Bram ^{[1
]}

van den Bongard, H. J. G. Desiree ^{[1
]}

机构：

[1] Univ Med Ctr Utrecht, Dept Radiotherapy, NL-3508 GA Utrecht, Netherlands

[2] Univ Med Ctr Utrecht, Dept Radiol, NL-3508 GA Utrecht, Netherlands

来源：

RADIATION ONCOLOGY | 2014年 / 9卷

关键词：

MRI; CT; Supine; Interobserver variability; Preoperative; GTV; Tumor bed; Breast cancer; Radiotherapy; MAGNETIC-RESONANCE; BOOST VOLUME; CANCER; RADIOTHERAPY; TUMOR; TRIAL; LOCALIZATION; FEASIBILITY; VARIABILITY; DIAGNOSIS;

D O I：

10.1186/1748-717X-9-63

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 [肿瘤学];

摘要：

Background: Accurate tumor bed delineation after breast-conserving surgery is important. However, consistency among observers on standard postoperative radiotherapy planning CT is low and volumes can be large due to seroma formation. A preoperative delineation of the tumor might be more consistent. Therefore, the purpose of this study was to determine the consistency of preoperative target volume delineation on CT and MRI for breast-conserving radiotherapy. Methods: Tumors were delineated on preoperative contrast-enhanced (CE) CT and newly developed 3D CE-MR images, by four breast radiation oncologists. Clinical target volumes (CTVs) were created by addition of a 1.5 cm margin around the tumor, excluding skin and chest wall. Consistency in target volume delineation was expressed by the interobserver variability. Therefore, the conformity index (CI), center of mass distance (dCOM) and volumes were calculated. Tumor characteristics on CT and MRI were scored by an experienced breast radiologist. Results: Preoperative tumor delineation resulted in a high interobserver agreement with a high median CI for the CTV, for both CT (0.80) and MRI (0.84). The tumor was missed on CT in 2/14 patients (14%). Leaving these 2 patients out of the analysis, CI was higher on MRI compared to CT for the GTV (p < 0.001) while not for the CTV (CT (0.82) versus MRI (0.84), p = 0.123). The dCOM did not differ between CT and MRI. The median CTV was 48 cm(3) (range 28-137 cm(3)) on CT and 59 cm(3) (range 30-153 cm(3)) on MRI (p < 0.001). Tumor shapes and margins were rated as more irregular and spiculated on CE-MRI. Conclusions: This study showed that preoperative target volume delineation resulted in small target volumes with a high consistency among observers. MRI appeared to be necessary for tumor detection and the visualization of irregularities and spiculations. Regarding the tumor delineation itself, no clinically relevant differences in interobserver variability were observed. These results will be used to study the potential for future MRI-guided and neoadjuvant radiotherapy.

引用

页数：9

共 36 条

[1]

On the feasibility of MRI-guided navigation to demarcate breast cancer for breast-conserving surgery [J].

Alderliesten, Tanja ;

Loo, Claudette ;

Paape, Anita ;

Muller, Sara ;

Rutgers, Emiel ;

Peeters, Marie-Jeanne Vrancken ;

Gilhuijs, Kenneth .

MEDICAL PHYSICS, 2010, 37 (06) :2617-2626

[2]

Impact of a higher radiation dose on local control and survival in breast-conserving therapy of early breast cancer:: 10-year results of the randomized boost versus no boost EORTC 22881-10882 trial [J].

Bartelink, Harry ;

Horiot, Jean-Claude ;

Poortmans, Philip M. ;

Struikmans, Henk ;

Van den Bogaert, Walter ;

Fourquet, Alain ;

Jager, Jos J. ;

Hoogenraad, Willem J. ;

Oei, S. Bing ;

Warlam-Rodenhuis, Carla C. ;

Pierart, Marianne ;

Collette, Laurence .

JOURNAL OF CLINICAL ONCOLOGY, 2007, 25 (22) :3259-3265

[3]

Breast boost: Are we missing the target? A dosimetric comparison of two boost techniques [J].

Benda, RK ;

Yasuda, G ;

Sethi, A ;

Gabram, SGA ;

Hinerman, RW ;

Mendenhall, NP .

CANCER, 2003, 97 (04) :905-909

[4]

Reducing interobserver variation of boost-CTV delineation in breast conserving radiation therapy using a pre-operative CT and delineation guidelines [J].

Boersma, Liesbeth J. ;

Janssen, Tomas ;

Elkhuizen, Paula H. M. ;

Poortmans, Philip ;

van der Sangen, Maurice ;

Scholten, Astrid N. ;

Hanbeukers, Bianca ;

Duppen, Joop C. ;

Hurkmans, Coen ;

van Vliet, Corine .

RADIOTHERAPY AND ONCOLOGY, 2012, 103 (02) :178-182

[5]

Simultaneous multi-modality ROI delineation in clinical practice [J].

Bol, Gijsbert H. ;

Kotte, Alexis N. T. J. ;

van der Heide, Uulke A. ;

Lagendijk, Jan J. W. .

COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE, 2009, 96 (02) :133-140

[6]

Phase 1 Clinical Trial of Stereotactic Body Radiation Therapy Concomitant With Neoadjuvant Chemotherapy for Breast Cancer [J].

Bondiau, Pierre-Yves ;

Courdi, Adel ;

Bahadoran, Phillipe ;

Chamorey, Emmanuel ;

Queille-Roussel, Catherine ;

Lallement, Michel ;

Birtwisle-Peyrottes, Isabelle ;

Chapellier, Claire ;

Pacquelet-Cheli, Sandrine ;

Ferrero, Jean-Marc .

INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2013, 85 (05) :1193-1199

[7]

Titanium clip placement to allow accurate tumour bed localisation following breast conserving surgery - Audit on behalf of the IMPORT Trial Management Group [J].

Coles, C. E. ;

Wilson, C. B. ;

Cumming, J. ;

Benson, J. R. ;

Forouhi, P. ;

Wilkinson, J. S. ;

Jena, R. ;

Wishart, G. C. .

EJSO, 2009, 35 (06) :578-582

[8]

Predictors of the risk of fibrosis at 10 years after breast conserving therapy for early breast cancer - A study based on the EORTC trial 22881-10882 'boost versus no boost' [J].

Collette, Sandra ;

Collette, Laurence ;

Budiharto, Tom ;

Horiot, Jean-Claude ;

Poortmans, Philip M. ;

Struikmans, Henk ;

Van den Bogaer, Walter ;

Fourquet, Alain ;

Jagerg, Jos J. ;

Hoogenraad, Willem ;

Mueller, Rolf-Peter ;

Kurtz, John ;

Morgan, David A. L. ;

Dubois, Jean-Bernard ;

Salamon, Emile ;

Mirimanoff, Rene ;

Bolla, Michel ;

Van der Hulst, Marleen ;

Warlam-Rodenhuis, Carla C. ;

Bartelink, Harry .

EUROPEAN JOURNAL OF CANCER, 2008, 44 (17) :2587-2599

[9]

Excised and irradiated volumes in relation to the tumor size in breast-conserving therapy [J].

den Hartogh, M. D. ;

van Asselen, B. ;

Monninkhof, E. M. ;

van den Bosch, M. A. A. J. ;

van Vulpen, M. ;

van Diest, P. J. ;

Gilhuijs, K. G. A. ;

Witkamp, A. J. ;

van de Bunt, L. ;

Mali, W. P. T. M. ;

van den Bongard, H. J. G. D. .

BREAST CANCER RESEARCH AND TREATMENT, 2011, 129 (03) :857-865

[10]

Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10 801 women in 17 randomised trials [J].

Darby S. ;

McGale P. ;

Correa C. ;

Taylor C. ;

Arriagada R. ;

Clarke M. ;

Cutter D. ;

Davies C. ;

Ewertz M. ;

Godwin J. ;

Gray R. ;

Pierce L. ;

Whelan T. ;

Wang Y. ;

Peto R. ;

Albain K. ;

Anderson S. ;

Barlow W. ;

Bergh J. ;

Bliss J. ;

Buyse M. ;

Cameron D. ;

Carrasco E. ;

Coates A. ;

Collins R. ;

Costantino J. ;

Cuzick J. ;

Davidson N. ;

Davies K. ;

Delmestri A. ;

Di Leo A. ;

Dowsett M. ;

Elphinstone P. ;

Evans V. ;

Gelber R. ;

Gettins L. ;

Geyer C. ;

Goldhirsch A. ;

Gregory C. ;

Hayes D. ;

Hill C. ;

Ingle J. ;

Jakesz R. ;

James S. ;

Kaufmann M. ;

Kerr A. ;

MacKinnon E. ;

McHugh T. ;

Norton L. ;

Ohashi Y. .

LANCET, 2011, 378 (9804) :1707-1716

← 1 2 3 4 →