| Title | Does registration of PET and planning CT images decrease interobserver and intraobserver variation in delineating tumor volumes for non-small-cell lung cancer? |
| Publication Type | Journal Article |
| Year of Publication | 2005 |
| Authors | Fox JL, Rengan R, O'Meara W, Yorke E, Erdi Y, Nehmeh S, Leibel SA, Rosenzweig KE |
| Journal | Int J Radiat Oncol Biol Phys |
| Volume | 62 |
| Issue | 1 |
| Pagination | 70-5 |
| Date Published | 2005 May 01 |
| ISSN | 0360-3016 |
| Keywords | Adult, Aged, Aged, 80 and over, Carcinoma, Non-Small-Cell Lung, Fluorodeoxyglucose F18, Humans, Lung Neoplasms, Middle Aged, Observer Variation, Positron-Emission Tomography, Radiopharmaceuticals, Radiotherapy Planning, Computer-Assisted, Tomography, X-Ray Computed |
| 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 intersection B)/(A union or logical sum 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. |
| DOI | 10.1016/j.ijrobp.2004.09.020 |
| Alternate Journal | Int J Radiat Oncol Biol Phys |
| PubMed ID | 15850904 |