Value of MRI T 2WI-TSE-BLADE sequence in accurately delineating the gross tumor volume of esophageal carcinoma based on pathological specimens / 中华放射肿瘤学杂志

ABSTRACT

Objective:To explore the value of BLADE sequence in determining the target range of esophageal cancer radiotherapy through the correlation and consistency between measured esophageal cancer length on the MRI-BLADE sequence and the surgical pathological specimens.Methods:Clinical data of 36 patients who were pathologically diagnosed with esophageal carcinoma and received preoperative esophageal MRI in the Affiliated Cancer Hospital of Zhengzhou University between January 2016 to June 2019 were collected. The CT, DWI and BLADE sequence images of all participants were collected and imported into the Monaco system, by which the correlation and consistency between the tumor length measured based on these three imaging methods were statistically compared. Furthermore, the differences in gross tumor volume (GTV) delineated by different physicians in different images were compared.Results:The correlation coefficients of the tumor length measured by CT, DWI and BLADE and pathological specimen length were 0.467, 0.723 and 0.896, respectively. The consistency analysis indicated that all the differences between the BLADE sequence and pathological specimen length were within the 95% consistency limit. The consistency and correlation between the BLADE sequence and actual tumor length were significantly better than those between the DWI sequence and CT images (both P<0.05). The volume of DWI and BLADE images obtained by four physicians was significantly smaller than that of CT images (both P<0.05). The differences in GTV delineated by different physicians by these three imaging methods were insignificant (all P>0.05), but the GTV delineated by the four physicians on the BLADE sequence were more similar (all P>0.05). Conclusions:BLADE sequence can help physicians to determine the upper and lower boundaries of esophageal tumors more accurately and reduce the differences in GTV delineation among different physicians. And it can effectively improve the unity of individual′s understanding of the scope of target area delineation, and improve the objectivity of clinicians′ judgment of GTV. BLADE sequence can be used as an important imaging tool for accurate target delineation in radiotherapy.