AI Article Synopsis
- Sole use of CT scans for determining tumor volume in oropharyngeal cancer can lead to inaccuracies; this study explores how MRI, PET, and physical exams can improve this process.
- Forty-one patients were analyzed, with doctors contouring three different tumor volumes based on various imaging methods and examining their overlaps using concordance indices.
- Results showed that the reference contours set by expert oncologists were significantly larger than those derived from CT/PET or CT/MRI alone, indicating that combining these imaging modalities with physical examination enhances the accuracy of tumor volume delineation.
Article Abstract
Introduction: Sole utilization of computed tomography (CT) scans in gross tumor volume (GTV) delineation for head-and-neck cancers is subject to inaccuracies. This study aims to evaluate contributions of magnetic resonance imaging (MRI), positron emission tomography (PET), and physical examination (PE) to GTV delineation in oropharyngeal cancer (OPC).
Methods: Forty-one patients with OPC were studied. All underwent contrast-enhanced CT simulation scans (CECTs) that were registered with pretreatment PETs and MRIs. For each patient, three sets of primary and nodal GTV were contoured. First, reference GTVs (GTVref) were contoured by the treating radiation oncologist (RO) using CT, MRI, PET, and PE findings. Additional GTVs were created using fused CT/PET scans (GTVctpet) and CT/MRI scans (GTVctmr) by two other ROs blinded to GTVref. To compare GTVs, concordance indices (CI) were calculated by dividing the respective overlap volumes by overall volumes. To evaluate the contribution of PE, composite GTVs derived from CT, MRI, and PET (GTVctpetmr) were compared with GTVref.
Results: For primary tumors, GTVref was significantly larger than GTVctpet and GTVctmr (p < 0.001). Although no significant difference in size was noted between GTVctpet and GTVctmr (p = 0.39), there was poor concordance between them (CI = 0.62). In addition, although CI (ctpetmr vs. ref) was low, it was significantly higher than CI (ctpet vs. ref) and CI (ctmr vs. ref) (p < 0.001), suggesting that neither modality should be used alone. Qualitative analyses to explain the low CI (ctpetmr vs. ref) revealed underestimation of mucosal disease when GTV was contoured without knowledge of PE findings. Similar trends were observed for nodal GTVs. However, CI (ctpet vs. ref), CI (ctmr vs. ref), and CI (ctpetmr vs. ref) were high (>0.75), indicating that although the modalities were complementary, the added benefit was small in the context of CECTs. In addition, PE did not aid greatly in nodal GTV delineation.
Conclusion: PET and MRI are complementary and combined use is ideal. However, the low CI (ctpetmr vs. ref) particularly for primary tumors underscores the limitations of defining GTVs using imaging alone. PE is invaluable and must be incorporated.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.ijrobp.2011.05.060 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Optical molecular imaging in oral- and oropharyngeal squamous cell carcinoma using a novel uPAR-targeting near-infrared imaging agent FG001 (ICG-Glu-Glu-AE105): An explorative phase II clinical trial.
Theranostics
January 2025
Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging (CMI), Copenhagen University Hospital, Rigshospitalet & Department of Biomedical Sciences, University of Copenhagen, Denmark.
: In oral and oropharyngeal squamous cell carcinoma (OSCC, OPSCC), frequent inadequate surgical margins highlight the importance of precise intraoperative identification and delineation of cancerous tissue for improving patient outcomes. : A prospective, open-label, single-center, single dose, exploratory phase II clinical trial (EudraCT 2022-001361-12) to assess the efficacy of the novel uPAR-targeting near-infrared imaging agent, FG001, for intraoperative detection of OSCC and OPSCC. Macroscopic tumor detection was quantified with sensitivity and intraoperative tumor-to-background ratio (TBR).
View Article and Find Full Text PDFInterpreting the patterns of local failure following postoperative volumetric-modulated arctherapy in oral cavity and oropharynx cancers: Impact of the different methods of analysis.
Cancer Radiother
December 2024
Department of Radiation Therapy, centre Jean-Perrin, Clermont-Ferrand, France; Inserm, U1240 IMoST, université Clermont-Auvergne, Clermont-Ferrand, France. Electronic address:
Purpose: Intensity-modulated radiation therapy or volumetric-modulated arctherapy is nowadays the recommended radiation technique for the treatment of head and neck cancers. However, by providing a significant dose gradient between target volumes and organs at risk, there is a risk of target missing and thus recurrence in case of inadequate delineation. It is therefore necessary to determine the origin of these recurrences to improve clinical practice.
View Article and Find Full Text PDFPatterns of loco-regional progression and patient outcomes after definitive-dose radiation therapy for anaplastic thyroid cancer.
Radiother Oncol
January 2025
Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, United States. Electronic address:
Article Synopsis
- This study investigates the progression patterns and outcomes of anaplastic thyroid cancer (ATC) patients with neck disease who received high-dose intensity-modulated radiation therapy (IMRT), focusing on those with unresected or partially resected tumors. !* -
- The analysis included 40 patients treated from 2010 to 2020, revealing a median overall survival of 7.1 months and a median progression-free survival of 7.4 months for those with locoregional disease. !* -
- The findings indicate that despite aggressive treatment, 53% of patients experienced loco-regional progression, predominantly in highly irradiated areas, emphasizing the need for improved targeting and strategy in treatment planning. !
Can dysphagia aspiration related structures (DARS) be spared in patients with oropharyngeal cancers? Dosimetric evaluation in a prospective study of DARS optimized intensity modulated radiation therapy.
J Cancer Res Ther
July 2024
Department of Radiation Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Parel, Mumbai, Maharashtra, India.
Article Synopsis
- - The study aimed to assess whether it is possible to protect the structures involved in swallowing and aspiration (DARS) during radiation therapy for head and neck cancer, while still effectively treating the tumors.
- - Researchers outlined specific target areas and dose limits for DARS in 35 patients, finding that the average dose received by these critical structures varied depending on the type of cancer and the size of the tumor volume.
- - Results indicated that sparing DARS was more difficult for patients with oropharyngeal cancers compared to laryngopharyngeal cancers, but it was achievable when the tumor volume was less than 150 cc or in patients with no or only one affected lymph node.
FGFR3::TACC3 fusions in head and neck carcinomas: a study of nine cases highlighting phenotypic heterogeneity, frequent HPV association, and a morphologically distinct subset in favor of a putative entity.
Virchows Arch
October 2024
Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
The FGFR3::TACC3 fusion has been reported in subsets of diverse cancers including urothelial and squamous cell carcinomas (SCC). However, the morphology of FGFR3::TACC3-positive head and neck carcinomas has not been well studied and it is unclear if this fusion represents a random event, or if it might characterize a morphologically distinct tumor type. We describe nine FGFR3::TACC3 fusion-positive head and neck carcinomas affecting six males and three females aged 38 to 89 years (median, 59).
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!