Comparison of five segmentation tools for 18F-fluoro-deoxy-glucose-positron emission tomography-based target volume definition in head and neck cancer.

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Publication year
2007Source
International Journal of Radiation Oncology, Biology, Physics, 69, 4, (2007), pp. 1282-1289ISSN
Publication type
Article / Letter to editor

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Organization
Radiation Oncology
Nuclear Medicine
Journal title
International Journal of Radiation Oncology, Biology, Physics
Volume
vol. 69
Issue
iss. 4
Page start
p. 1282
Page end
p. 1289
Subject
CTR 1: Functional imaging; N4i 1: Pathogenesis and modulation of inflammation; ONCOL 3: Translational research; ONCOL 5: Aetiology, screening and detection; UMCN 1.1: Functional ImagingAbstract
PURPOSE: Target-volume delineation for radiation treatment to the head and neck area traditionally is based on physical examination, computed tomography (CT), and magnetic resonance imaging. Additional molecular imaging with (18)F-fluoro-deoxy-glucose (FDG)-positron emission tomography (PET) may improve definition of the gross tumor volume (GTV). In this study, five methods for tumor delineation on FDG-PET are compared with CT-based delineation. METHODS AND MATERIALS: Seventy-eight patients with Stages II-IV squamous cell carcinoma of the head and neck area underwent coregistered CT and FDG-PET. The primary tumor was delineated on CT, and five PET-based GTVs were obtained: visual interpretation, applying an isocontour of a standardized uptake value of 2.5, using a fixed threshold of 40% and 50% of the maximum signal intensity, and applying an adaptive threshold based on the signal-to-background ratio. Absolute GTV volumes were compared, and overlap analyses were performed. RESULTS: The GTV method of applying an isocontour of a standardized uptake value of 2.5 failed to provide successful delineation in 45% of cases. For the other PET delineation methods, volume and shape of the GTV were influenced heavily by the choice of segmentation tool. On average, all threshold-based PET-GTVs were smaller than on CT. Nevertheless, PET frequently detected significant tumor extension outside the GTV delineated on CT (15-34% of PET volume). CONCLUSIONS: The choice of segmentation tool for target-volume definition of head and neck cancer based on FDG-PET images is not trivial because it influences both volume and shape of the resulting GTV. With adequate delineation, PET may add significantly to CT- and physical examination-based GTV definition.
This item appears in the following Collection(s)
- Academic publications [202914]
- Electronic publications [101091]
- Faculty of Medical Sciences [80065]
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