| Zhang Yumei,Gong Guanzhong,Cao Xiujuan,Han Yunwei,Zhou Jing,Lu Heming,Yin Yong.A comparative study on the delineation of gross tumor volume and lymph nodes of nasopharyngeal carcinoma patients using CT/MRI/and PET-CT[J].Chinese Journal of Radiological Medicine and Protection,2021,41(9):653-658 |
| A comparative study on the delineation of gross tumor volume and lymph nodes of nasopharyngeal carcinoma patients using CT/MRI/and PET-CT |
| Received:December 08, 2020 |
| DOI：10.3760/cma.j.issn.0254-5098.2021.09.003 |
| KeyWords:Nasopharyngeal neoplasms Computerized tomography Magnetic resonance imaging Positron emission computed tomography |
| FundProject:山东省自然科学基金（ZR2020MH227）；广西重点研发计划（AB17195005） |
| Author Name | Affiliation | E-mail | | Zhang Yumei | The Clinical Hospital of Southwest Medical University, Luzhou 646000, China | | | Gong Guanzhong | Department of Radiotherapy, Shandong Cancer Hospital and Institute, Shandong First Medical University, and Shandong Academy of Medical Sciences, Jinan 250117, China | | | Cao Xiujuan | Department of Radiotherapy, Shandong Cancer Hospital and Institute, Shandong First Medical University, and Shandong Academy of Medical Sciences, Jinan 250117, China | | | Han Yunwei | The Clinical Hospital of Southwest Medical University, Luzhou 646000, China | | | Zhou Jing | Department of Radiotherapy, Shandong Cancer Hospital and Institute, Shandong First Medical University, and Shandong Academy of Medical Sciences, Jinan 250117, China | | | Lu Heming | Department of Radiotherapy, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, China | | | Yin Yong | The Clinical Hospital of Southwest Medical University, Luzhou 646000, China | yinyongsd@126.com |
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| Abstract:: |
| Objective To compare the differences in the delineation of the gross tumor volume (GTV) and lymph nodes of nasopharyngeal carcinoma (NPC) patients using computerized tomography (CT), magnetic resonance imaging (MRI), and 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT), and to investigate the optimal standard uptake value (SUV; relative to the MRI-based delineation) for the automatic delineation of GTV using PET. Methods A total of 53 NPC patients proposing to receive radiotherapy were selected for this study. The CT, MRI, and PET images of each patient were obtained before radiotherapy. Then GTV and positive lymph nodes were delineated on these three types of images. They were individually named GTVMRI, GTVCT, GTVPET2.5 (SUV=2.5), LymphMRI, LymphCT, and LymphPET2.5 and compared. The GTV∩2.5 (overlapped GTV) was obtained through the alignment of MRI and PET/CT images. Meanwhile, GTV was delineated on PET images using thresholds of SUV=4.0, 4.5, 5.0, and 5.6, obtaining GTVPET4.0, GTVPET4.5, GTVPET5.0, and GTVPET5.6. Then their volume and Dice similarity coefficients (DSCs) were compared. Results Compared to GTVMRI, GTVCT decreased by 1.73% (P>0.05) and GTVPET2.5 increased by 21.34% (t=-3.52, P < 0.05) in the three types of images. The volume of LymphPET2.5 was 1.61 and 1.87 times the volume of LymphMRI and LymphCT, respectively (t=-4.12, -5.18; P< 0.05). The volume of high-SUV lymph nodes was 4.07 times the volume of lymph nodes with low SUVs or SUV=0 (t=5.50, P< 0.05) on PET images. The DSC between GTVPET4.0and GTVMRI was 0.78 ±0.27, which was lower than that between GTVPET2.5 and GTVMRI (0.84 ±0.18). However, GTVPET4.0 approximated to GTV∩2.5 (P>0.05). Conclusions Compared to CT and 18F-FDG PET/CT, MRI shows more accurate boundaries of GTV and lymph nodes. When 18F-FDG PET/CT was adopted to automatically delineate GTV, the GTV delineated using SUV=4.0 was closer to GTVMRI. |
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