Validation of a 4D-PET Maximum Intensity Projection for Delineation of an Internal Target Volume

Callahan, Jason; Kron, Tomas; Schneider-Kolsky, Michal Elisabeth; Dunn, Leon; Thompson, Margaret A.; Siva, Shankar; Aarons, Yolanda; Binns, David; Hicks, Rodney J.

doi:10.1016/j.ijrobp.2013.02.030

Cited by 36 publications

(29 citation statements)

References 18 publications

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“…This is particularly evident for lower lobe tumors. Our findings are consistent with previous phantom 3,5 and clinical studies investigating the impact of target delineation using 3D PET/CT when compared with 4DCT 10,11 or 4D PET/CT [12][13][14][15][16] acquisition techniques. Importantly, in this study, we demonstrate that these differences in delineation result in significant dosimetric consequences in the context of radiotherapy treatment delivery.…”

Section: Discussionsupporting

confidence: 91%

“…Using the MIM Maestro software (MIM 5.4.4, MIM Software Inc., Cleveland, OH), an equivalent PET MIP data set was reconstructed from the respiratory correlated PET data. 5 This PET (MIP) image demonstrates the maximum PET avidity of each voxel across the respiratory cycle. A CT average (AVG) data set was reconstructed from the 4D-PET/CT data, in which the density of each voxel is represented as the average density of that voxel across all respiratory phases.…”

Section: Pet/ct Acquisitionmentioning

confidence: 99%

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Dosimetric Consequences of 3D Versus 4D PET/CT for Target Delineation of Lung Stereotactic Radiotherapy

Chesson

Callahan

Hardcastle

et al. 2015

Journal of Thoracic Oncology

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Section: Discussionsupporting

confidence: 91%

Section: Pet/ct Acquisitionmentioning

confidence: 99%

Dosimetric Consequences of 3D Versus 4D PET/CT for Target Delineation of Lung Stereotactic Radiotherapy

Chesson

Callahan

Hardcastle

et al. 2015

Journal of Thoracic Oncology

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“…Wang et al16 compared GTV determined from average 4DPET and average 4DCT, and proved that GTV PET at SUV 2.5 , SUV 20% correlated well with GTV CT in tumor length, VR, and CI, but the CIs (0.58, 0.57) were also not ideal. Callahan et al19 used 4DPET to create “PET-MIP” image sets and segmented PET ITVs at thresholds ranging from 20% to 40% of maximum SUV. The investigators compared these volumes to ITVs drawn by radiation oncologists on the 4DCTMIP and found good overlap between PET-MIP volumes and CT-MIP volumes, but poor overlap between FBPET volumes and CT-MIP volumes 19.…”

Section: Discussionmentioning

confidence: 99%

“…Callahan et al19 used 4DPET to create “PET-MIP” image sets and segmented PET ITVs at thresholds ranging from 20% to 40% of maximum SUV. The investigators compared these volumes to ITVs drawn by radiation oncologists on the 4DCTMIP and found good overlap between PET-MIP volumes and CT-MIP volumes, but poor overlap between FBPET volumes and CT-MIP volumes 19. Hanna et al’s18 work compared ITV determined from FB-PET/CT with modified 4DCT-MIP for 16 patients with NSCLC receiving SABRT using the concordance index (equivalent to CI in our study).…”

Section: Discussionmentioning

confidence: 99%

A comparative study of target volumes based on <sup>18</sup>F-FDG PET-CT and ten phases of 4DCT for primary thoracic squamous esophageal cancer

Guo

Zhang

et al. 2017

OTT

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PurposeTo investigate the correlations in target volumes based on 18F-FDG PET/CT and four-dimensional CT (4DCT) to detect the feasibility of implementing PET in determining gross target volumes (GTV) for tumor motion for primary thoracic esophageal cancer (EC).MethodsThirty-three patients with EC sequentially underwent contrast-enhanced 3DCT, 4DCT, and 18F-FDG PET-CT thoracic simulation. The internal gross target volume (IGTV)10 was obtained by combining the GTV from ten phases of 4DCT. The GTVs based on PET/CT images were defined by setting of different standardized uptake value thresholds and visual contouring. The difference in volume ratio, conformity index (CI), and degree of inclusion (DI) between IGTV10 and GTVPET was compared.ResultsThe images from 20 patients were suitable for further analysis. The optimal volume ratio of 0.95±0.32, 1.06±0.50, 1.07±0.49 was at standardized uptake value (SUV)2.5, SUV20%, or manual contouring. The mean CIs were from 0.33 to 0.54. The best CIs were at SUV2.0 (0.51±0.11), SUV2.5 (0.53±0.13), SUV20% (0.53±0.12), and manual contouring (0.54±0.14). The mean DIs of GTVPET in IGTV10 were from 0.60 to 0.90, and the mean DIs of IGTV10 in GTVPET ranged from 0.35 to 0.78. A negative correlation was found between the mean CI and different SUV (P=0.000).ConclusionNone of the PET-based contours had both close spatial and volumetric approximation to the 4DCT IGTV10. Further evaluation and optimization of PET as a tool for target identification are required.

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“…The internal tumor volume (ITV), the union of clinical tumor volumes in all respiratory phases, is the recommended target by the International Commission on Radiation Units and Measurements (ICRU 50 and 62) as the treatment target to account for respiratory‐induced tumor motion. Alternatively, the ITV has been also obtained via generating maximum intensity projection (MIP) image 6, 7, 8. The full prescription dose is planned to cover the planning tumor volume (ITV+margin), which may include nearby OAR causing normal tissue toxicity 4.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of automatic contour propagation in T2‐weighted 4DMRI for normal‐tissue motion assessment using internal organ‐at‐risk volume (IRV)

Zhang

Markova

García

et al. 2018

J Applied Clin Med Phys

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PurposeThe purpose of this study was to evaluate the quality of automatically propagated contours of organs at risk (OARs) based on respiratory‐correlated navigator‐triggered four‐dimensional magnetic resonance imaging (RC‐4DMRI) for calculation of internal organ‐at‐risk volume (IRV) to account for intra‐fractional OAR motion.Methods and MaterialsT2‐weighted RC‐4DMRI images were of 10 volunteers acquired and reconstructed using an internal navigator‐echo surrogate and concurrent external bellows under an IRB‐approved protocol. Four major OARs (lungs, heart, liver, and stomach) were delineated in the 10‐phase 4DMRI. Two manual‐contour sets were delineated by two clinical personnel and two automatic‐contour sets were propagated using free‐form deformable image registration. The OAR volume variation within the 10‐phase cycle was assessed and the IRV was calculated as the union of all OAR contours. The OAR contour similarity between the navigator‐triggered and bellows‐rebinned 4DMRI was compared. A total of 2400 contours were compared to the most probable ground truth with a 95% confidence level (S95) in similarity, sensitivity, and specificity using the simultaneous truth and performance level estimation (STAPLE) algorithm.ResultsVisual inspection of automatically propagated contours finds that approximately 5–10% require manual correction. The similarity, sensitivity, and specificity between manual and automatic contours are indistinguishable (P > 0.05). The Jaccard similarity indexes are 0.92 ± 0.02 (lungs), 0.89 ± 0.03 (heart), 0.92 ± 0.02 (liver), and 0.83 ± 0.04 (stomach). Volume variations within the breathing cycle are small for the heart (2.6 ± 1.5%), liver (1.2 ± 0.6%), and stomach (2.6 ± 0.8%), whereas the IRV is much larger than the OAR volume by: 20.3 ± 8.6% (heart), 24.0 ± 8.6% (liver), and 47.6 ± 20.2% (stomach). The Jaccard index is higher in navigator‐triggered than bellows‐rebinned 4DMRI by 4% (P < 0.05), due to the higher image quality of navigator‐based 4DMRI.ConclusionAutomatic and manual OAR contours from Navigator‐triggered 4DMRI are not statistically distinguishable. The navigator‐triggered 4DMRI image provides higher contour quality than bellows‐rebinned 4DMRI. The IRVs are 20–50% larger than OAR volumes and should be considered in dose estimation.

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Validation of a 4D-PET Maximum Intensity Projection for Delineation of an Internal Target Volume

Cited by 36 publications

References 18 publications

Dosimetric Consequences of 3D Versus 4D PET/CT for Target Delineation of Lung Stereotactic Radiotherapy

Dosimetric Consequences of 3D Versus 4D PET/CT for Target Delineation of Lung Stereotactic Radiotherapy

A comparative study of target volumes based on <sup>18</sup>F-FDG PET-CT and ten phases of 4DCT for primary thoracic squamous esophageal cancer

Evaluation of automatic contour propagation in T2‐weighted 4DMRI for normal‐tissue motion assessment using internal organ‐at‐risk volume (IRV)

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