Addition of MRI for CT-based pancreatic tumor delineation: a feasibility study

Gurney‐Champion, Oliver J.; Versteijne, Eva; Horst, Astrid van der; Lens, E.; Rütten, Heidi; Heerkens, H.D.; Paardekooper, G.; Berbée, Maaike; Rasch, Coen R. N.; Stoker, Jaap; Engelbrecht, Marc R.; Herk, Marcel van; Nederveen, Aart J.; Klaassen, Remy; Laarhoven, Hanneke W. M. van; Tienhoven, Geertjan van; Bel, Arjan

doi:10.1080/0284186x.2017.1304654

Cited by 28 publications

(32 citation statements)

References 24 publications

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“…This study has some limitations. In our study a 1.5-Tesla MRI system was used, compared to Gurney-Champion OJ and Dalah E studies [22,35]. Both 1.5-Tesla and 3-Tesla MRI showed advantages and disadvantages, as reported in several studies.…”

Section: Discussionmentioning

confidence: 85%

“…CT þ MRI showed smaller variations (root-mean-square SD ¼ 0.59 cm) in six out of eight delineated structures compared to CT-only (root-mean-square SD ¼ 0.72 cm). However, larger variations remained close to biliary stents and pathological lymph nodes [22]. A report of an International contouring symposium of expert gastrointestinal radiation oncologists comparing CT and MRI GTV contouring, has recently been published [23].…”

Section: Discussionmentioning

confidence: 99%

“…Preliminary experience evaluating the role of MRI in target delineation, showed that the MRI decreased the local observer variation compared to CT alone and smaller target volumes could be obtained. However, even with MRI the observer variations were large and authors concluded that more detailed instructions and better instruction compliance are required to further improve delineations [22].…”

Section: Introductionmentioning

confidence: 99%

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Magnetic resonance imaging (MRI) compared with computed tomography (CT) for interobserver agreement of gross tumor volume delineation in pancreatic cancer: a multi-institutional contouring study on behalf of the AIRO group for gastrointestinal cancers

et al. 2019

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Genovesi (2019) Magnetic resonance imaging (MRI) compared with computed tomography (CT) for interobserver agreement of gross tumor volume delineation in pancreatic cancer: a multiinstitutional contouring study on behalf of the AIRO group for gastrointestinal cancers, Acta Oncologica, 58:4, 439-447, ABSTRACT Background: Due to the high soft tissue resolution, magnetic resonance imaging (MRI) could improve the accuracy of pancreatic tumor delineation in radiation treatment planning. A multi-institutional study was proposed to evaluate the impact of MRI on inter-observer agreement in gross tumor volume (GTV) and duodenum delineation for pancreatic cancer compared with computer tomography (CT). Material and Methods: Two clinical cases of borderline resectable (Case 1) and unresectable (Case 2) pancreatic cancer were selected. In two sequential steps, diagnostic contrast-enhanced CT scan and MRI sequences were sent to the participating centers. CT-GTVs were contoured while blinded to MRI data sets. DICE index was used to evaluate the spatial overlap accuracy. Results: Thirty-one radiation oncologists from different Institutions submitted the delineated volumes. CT-and MRI-GTV mean volumes were 21.6 ± 9.0 cm 3 and 17.2 ± 6.0 cm 3 , respectively for Case 1, and 31.3 ± 15.6 cm 3 and 33.2 ± 20.2 cm 3 , respectively for Case 2. Resulting MRI-GTV mean volume was significantly smaller than CT-GTV in the borderline resectable case (p < .05). A substantial agreement was shown by the median DICE index for CT-and MRI-GTV resulting as 0.74 (IQR: 0.67-0.75) and 0.61 (IQR: 0.57-0.67) for Case 1; a moderate agreement was instead reported for Case 2: 0.59 (IQR:0.52-0.66) and 0.53 (IQR:0.42-0.62) for CT-and MRI-GTV, respectively. Conclusion: Diagnostic MRI resulted in smaller GTV in borderline resectable case with a substantial agreement between observers, and was comparable to CT scan in interobserver variability, in both cases. The greater variability in the unresectable case underlines the critical issues related to the outlining when vascular structures are more involved. The integration of MRI with contrast-enhancement CT, thanks to its high definition of tumor relationship with neighboring vessels, could offer a greater accuracy of target delineation.

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Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Magnetic resonance imaging (MRI) compared with computed tomography (CT) for interobserver agreement of gross tumor volume delineation in pancreatic cancer: a multi-institutional contouring study on behalf of the AIRO group for gastrointestinal cancers

et al. 2019

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“…Delineation of PDAC based on CT images was found to result in large interobserver variations due to poor soft‐tissue contrast . The superior soft‐tissue contrast of magnetic resonance imaging (MRI) may improve the accuracy and precision of tumor detection and delineation for PDAC . Furthermore, MRI can be repeatedly used in fractionated radiation therapy for characterization of tumor and organ motion and deformation patterns .…”

Section: Introductionmentioning

confidence: 99%

“…[5][6][7] The superior soft-tissue contrast of magnetic resonance imaging (MRI) may improve the accuracy and precision of tumor detection and delineation for PDAC. 8 Furthermore, MRI can be repeatedly used in fractionated radiation therapy for characterization of tumor and organ motion and deformation patterns. 9 Recent studies suggest that 4D-CT is unable to accurately measure respiratory-induced pancreatic tumor motion due to both resorting artifacts and poor soft-tissue contrast.…”

Section: Introductionmentioning

confidence: 99%

Quantification of MRI visibility and artifacts at 3T of liquid fiducial marker in a pancreas tissue‐mimicking phantom

et al. 2017

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The liquid fiducial marker causes signal voids on MRI due to its absence of water hydrogen atoms without strongly affecting the magnetic field in the surrounding tissue. The alteration of the static magnetic field was found to be the main effect leading to the visibility of the solid fiducial markers. Hence, especially when a low level of image distortion is required, MRI characteristics of the liquid marker surpass those of solid gold markers currently being used for IGRT of PDAC.

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Deformable image registration in radiation therapy

Dowling

O'Connor

2020

J of Medical Radiation Sci

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Addition of MRI for CT-based pancreatic tumor delineation: a feasibility study

Abstract: The availability of MRI images during target delineation of pancreatic cancer on 3DCT and 4DCT resulted in smaller target volumes and reduced the interobserver variation in six out of eight delineated structures.

Cited by 28 publications

References 24 publications

Magnetic resonance imaging (MRI) compared with computed tomography (CT) for interobserver agreement of gross tumor volume delineation in pancreatic cancer: a multi-institutional contouring study on behalf of the AIRO group for gastrointestinal cancers

Magnetic resonance imaging (MRI) compared with computed tomography (CT) for interobserver agreement of gross tumor volume delineation in pancreatic cancer: a multi-institutional contouring study on behalf of the AIRO group for gastrointestinal cancers

Quantification of MRI visibility and artifacts at 3T of liquid fiducial marker in a pancreas tissue‐mimicking phantom

Deformable image registration in radiation therapy

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