Does registration of PET and planning CT images decrease interobserver and intraobserver variation in delineating tumor volumes for non-small-cell lung cancer? Journal Article
| Authors: | Fox, J. L.; Rengan, R.; O'meara, W.; Yorke, E.; Erdi, Y.; Nehmeh, S.; Leibel, S. A.; Rosenzweig, K. E. |
| Article Title: | Does registration of PET and planning CT images decrease interobserver and intraobserver variation in delineating tumor volumes for non-small-cell lung cancer? |
| Abstract: | Purpose: To compare tumor volume delineation using registered positron emission tomography (PET)/CT vs. side-by-side image sets. Methods and Materials: A total of 19 patients with non-small-cell lung cancer had 18-fluorine- deoxyglucose (FDG)-PET scans registered with planning CT scans. The disease was Stage I-II in 26%, IIIA in 42%, and IIIB in 32%. Two radiation oncologists contoured 9 tumor volumes using registered images (registered) and 10 using separate FDG-PET images as a guide (nonregistered). A third physician, who had done the treatment planning for these patients a median of 40 months before using registered images, repeated all contours: 10 on registered images (registered/registered) and 9 without registration (registered/nonregistered). Each pair of volumes (A and B) was compared. Quantitative comparison used the concordance index, (A∩B)/(A∪B). For qualitative analysis, pairs of volumes were projected onto digitally reconstructed radiographs. The differences were graded as insignificant, minor, moderate, or major. Results: The median interobserver percentage of concordance among nonregistered pairs was 61% vs. 70% in the registered group (p <0.05). On qualitative analysis, in the nonregistered group, the differences were insignificant in 5, minor in 3, and moderate in 2 of 10. The differences in the registered group were insignificant in 7 and minor in 2 of 9. The median intraobserver percentage of concordance in the registered/nonregistered group was 58% vs. 71% in the registered/registered group (p = 0.10). On qualitative analysis, the intraobserver differences in the registered/nonregistered group were insignificant in 2, minor in 2, moderate in 0, and major in 5 of 9. In the registered/registered group, the differences were insignificant in 2, minor in 6, moderate in 2, and major in 0 of 10. Conclusion: Registration of FDG-PET and planning CT images results in greater consistency in tumor volume delineation. © 2005 Elsevier Inc. |
| Keywords: | adult; clinical article; controlled study; aged; aged, 80 and over; middle aged; treatment planning; comparative study; radiation dose; cancer staging; positron emission tomography; radiopharmaceuticals; computer assisted tomography; observer variation; tumor volume; lung non small cell cancer; carcinoma, non-small-cell lung; lung neoplasms; lung cancer; tomography, x-ray computed; oncology; disease severity; computerized tomography; tumors; fdg-pet; fluorodeoxyglucose f 18; fluorodeoxyglucose f18; positron-emission tomography; tumor volumes; physician; glucose; radiotherapy planning, computer-assisted; patient treatment; time series analysis; ct; non-small-cell lung cancer; image registration; qualitative analysis; concordance index; radiotherapy planning; drug dosage; pulmonary diseases; radiographs |
| Journal Title: | International Journal of Radiation Oncology, Biology, Physics |
| Volume: | 62 |
| Issue: | 1 |
| ISSN: | 0360-3016 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2005-05-01 |
| Start Page: | 70 |
| End Page: | 75 |
| Language: | English |
| DOI: | 10.1016/j.ijrobp.2004.09.020 |
| PUBMED: | 15850904 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 79" - "Export Date: 24 October 2012" - "CODEN: IOBPD" - "Source: Scopus" |
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