WANG Li-ning,LI Jian-bin,XU Min,ZHANG Ying-jie,MA Zhi-fang,HUANG Yong,LI Feng-xiang,WANG Wei,WANG Su-zhen.Impact of delineator and delineating criteria on the target delineation of the peripheral lung cancer based on four-dimensional computed tomography[J].Chinese Journal of Radiological Medicine and Protection,2012,32(5):494-497
Impact of delineator and delineating criteria on the target delineation of the peripheral lung cancer based on four-dimensional computed tomography
Received:January 21, 2012  
DOI:10.3760/cma.j.issn.0254-5098.2012.05.011
KeyWords:Peripheral lung cancer  Target delineation criteria  Four-dimensional computed tomography
FundProject:山东省科技发展计划项目(2012GSF11839);山东省自然科学基金项目(ZR2011HM004)
Author NameAffiliationE-mail
WANG Li-ning 乳山市人民医院肿瘤科  
LI Jian-bin Department of Radiation Oncology, Shandong Cancer Hospital & Institute, Jinan 250117, China lijianbin@msn.com 
XU Min Department of Radiation Oncology, Shandong Cancer Hospital & Institute, Jinan 250117, China  
ZHANG Ying-jie Department of Radiation Oncology, Shandong Cancer Hospital & Institute, Jinan 250117, China  
MA Zhi-fang Department of Radiation Oncology, Shandong Cancer Hospital & Institute, Jinan 250117, China  
HUANG Yong Department of Radiation Oncology, Shandong Cancer Hospital & Institute, Jinan 250117, China  
LI Feng-xiang Department of Radiation Oncology, Shandong Cancer Hospital & Institute, Jinan 250117, China  
WANG Wei Department of Radiation Oncology, Shandong Cancer Hospital & Institute, Jinan 250117, China  
WANG Su-zhen Department of Radiation Oncology, Shandong Cancer Hospital & Institute, Jinan 250117, China  
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Abstract::
      Objective To investigate the impact of delineator and delineating criteria on the target delineation of the peripheral lung cancer based on four-dimensional computed tomography (4D-CT).Methods The 4D simulation CT images of twelve patients with peripheral lung cancer were selected. Before and after the establishment of the target delineation criteria, six radiation oncologists were asked to delineate the targets based on 4D-CT images at the end-inhalation phase (0%), end-exhalation phase (50%), and three-dimensional computed tomography (3D-CT) images respectively. The delineated targets were denominated as GTV0, GTV50, GTV3D. IGTVIN+EX was created by combining GTV0 and GTV50. IGTVMIP was delineated based on the maximum intensity projection (MIP) of 4D-CT. The inter- and intra-observer variability before and after the establishment of the delineation criteria was compared. Results The mean coefficients of variation of GTV0,GTV50,GTV3D,IGTVMIP and IGTVIN+EX delineated by the six delineators before and after the establishment of the delineation criteria were 0.50±0.25 vs 0.24±0.10, 0.52±0.38 vs 0.26±0.12, 0.45±0.19 vs0.20±0.07, 0.54±0.27 vs 0.23±0.09 and 0.44±0.23 vs 0.26±0.09, respectively. The differences were statistically significant(t=3.38,2.44,3.60,4.20,3.11,P<0.05). No statistically significant difference was found in the volume of the same target for GTV0, GTV50, GTV3D, IGTVMIP and IGTVIN+EX delineated by the six oncologists before and after the establishment of the delineation criteria. For delineator 3 and 6, the differences of GTV0, GTV50,IGTVIN+EX before and after establishment of the delineation criteria were statistically significant(t=2.46,2.91,3.28,P<0.05;t=2.40,2.79,3.22,P<0.05).For delineator 4, the differences of GTV0, GTV50,IGTVIN+EX, IGTVMIP,GTV3Dbefore and after establishment of the delineation criteria were statistically significant(t=2.70,3.21,3.04,3.99,3.00,P<0.05).Conclusions The unified delineation criteria can significantly reduce the inter-observer variability in delineating the GTVs based on 3D-CT or 4D-CT images, and in delineating the IGTVMIP based on 4D-CT images of peripheral lung cancer patients. However, regarding the same delineator, various influences of the unified delineation criteria on the target delineation are observed.
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