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The role of 18F-FDG PET in minimizing variability in gross tumor volume delineation of soft tissue sarcomas.
Najem, Elie; Marin, Thibault; Zhuo, Yue; Lahoud, Rita Maria; Tian, Fei; Beddok, Arnaud; Rozenblum, Laura; Xing, Fangxu; Moteabbed, Maryam; Lim, Ruth; Liu, Xiaofeng; Woo, Jonghye; Lostetter, Stephen John; Lamane, Abdallah; Chen, Yen-Lin Evelyn; Ma, Chao; El Fakhri, Georges.
Affiliation
  • Najem E; Gordon Center for Medical Imaging, Radiology Department, Massachusetts General Hospital - Harvard Medical School, 125 Nashua St., 25 Shattuck St., Boston, MA 02114, USA.
  • Marin T; Yale PET Center, Dept. of Radiology and Biomedical Imaging, Yale University, 801 Howard Avenue, New Haven, CT 06520, USA.
  • Zhuo Y; Yale PET Center, Dept. of Radiology and Biomedical Imaging, Yale University, 801 Howard Avenue, New Haven, CT 06520, USA.
  • Lahoud RM; Gordon Center for Medical Imaging, Radiology Department, Massachusetts General Hospital - Harvard Medical School, 125 Nashua St., 25 Shattuck St., Boston, MA 02114, USA.
  • Tian F; Gordon Center for Medical Imaging, Radiology Department, Massachusetts General Hospital - Harvard Medical School, 125 Nashua St., 25 Shattuck St., Boston, MA 02114, USA.
  • Beddok A; Gordon Center for Medical Imaging, Radiology Department, Massachusetts General Hospital - Harvard Medical School, 125 Nashua St., 25 Shattuck St., Boston, MA 02114, USA.
  • Rozenblum L; Gordon Center for Medical Imaging, Radiology Department, Massachusetts General Hospital - Harvard Medical School, 125 Nashua St., 25 Shattuck St., Boston, MA 02114, USA.
  • Xing F; Gordon Center for Medical Imaging, Radiology Department, Massachusetts General Hospital - Harvard Medical School, 125 Nashua St., 25 Shattuck St., Boston, MA 02114, USA.
  • Moteabbed M; Gordon Center for Medical Imaging, Radiology Department, Massachusetts General Hospital - Harvard Medical School, 125 Nashua St., 25 Shattuck St., Boston, MA 02114, USA; Radiation Oncology Department, Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114, USA.
  • Lim R; Yale PET Center, Dept. of Radiology and Biomedical Imaging, Yale University, 801 Howard Avenue, New Haven, CT 06520, USA.
  • Liu X; Yale PET Center, Dept. of Radiology and Biomedical Imaging, Yale University, 801 Howard Avenue, New Haven, CT 06520, USA.
  • Woo J; Gordon Center for Medical Imaging, Radiology Department, Massachusetts General Hospital - Harvard Medical School, 125 Nashua St., 25 Shattuck St., Boston, MA 02114, USA.
  • Lostetter SJ; Gordon Center for Medical Imaging, Radiology Department, Massachusetts General Hospital - Harvard Medical School, 125 Nashua St., 25 Shattuck St., Boston, MA 02114, USA.
  • Lamane A; Gordon Center for Medical Imaging, Radiology Department, Massachusetts General Hospital - Harvard Medical School, 125 Nashua St., 25 Shattuck St., Boston, MA 02114, USA.
  • Chen YE; Gordon Center for Medical Imaging, Radiology Department, Massachusetts General Hospital - Harvard Medical School, 125 Nashua St., 25 Shattuck St., Boston, MA 02114, USA; Radiation Oncology Department, Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114, USA.
  • Ma C; Yale PET Center, Dept. of Radiology and Biomedical Imaging, Yale University, 801 Howard Avenue, New Haven, CT 06520, USA.
  • El Fakhri G; Yale PET Center, Dept. of Radiology and Biomedical Imaging, Yale University, 801 Howard Avenue, New Haven, CT 06520, USA. Electronic address: georges.elfakhri@yale.edu.
Radiother Oncol ; 194: 110186, 2024 05.
Article in En | MEDLINE | ID: mdl-38412906
ABSTRACT

BACKGROUND:

Accurate gross tumor volume (GTV) delineation is a critical step in radiation therapy treatment planning. However, it is reader dependent and thus susceptible to intra- and inter-reader variability. GTV delineation of soft tissue sarcoma (STS) often relies on CT and MR images.

PURPOSE:

This study investigates the potential role of 18F-FDG PET in reducing intra- and inter-reader variability thereby improving reproducibility of GTV delineation in STS, without incurring additional costs or radiation exposure. MATERIALS AND

METHODS:

Three readers performed independent GTV delineation of 61 patients with STS using first CT and MR followed by CT, MR, and 18F-FDG PET images. Each reader performed a total of six delineation trials, three trials per imaging modality group. Dice Similarity Coefficient (DSC) score and Hausdorff distance (HD) were used to assess both intra- and inter-reader variability using generated simultaneous truth and performance level estimation (STAPLE) GTVs as ground truth. Statistical analysis was performed using a Wilcoxon signed-ranked test.

RESULTS:

There was a statistically significant decrease in both intra- and inter-reader variability in GTV delineation using CT, MR 18F-FDG PET images vs. CT and MR images. This was translated by an increase in the DSC score and a decrease in the HD for GTVs drawn from CT, MR and 18F-FDG PET images vs. GTVs drawn from CT and MR for all readers and across all three trials.

CONCLUSION:

Incorporation of 18F-FDG PET into CT and MR images decreased intra- and inter-reader variability and subsequently increased reproducibility of GTV delineation in STS.
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Full text: 1 Database: MEDLINE Main subject: Sarcoma / Magnetic Resonance Imaging / Fluorodeoxyglucose F18 / Positron-Emission Tomography / Tumor Burden Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: En Year: 2024 Type: Article
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Full text: 1 Database: MEDLINE Main subject: Sarcoma / Magnetic Resonance Imaging / Fluorodeoxyglucose F18 / Positron-Emission Tomography / Tumor Burden Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: En Year: 2024 Type: Article