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

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 (G...

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Veröffentlicht in:Acta oncologica 2019-04, Vol.58 (4), p.439-447
Hauptverfasser: Caravatta, Luciana, Cellini, Francesco, Simoni, Nicola, Rosa, Consuelo, Niespolo, Rita Marina, Lupattelli, Marco, Picardi, Vincenzo, Macchia, Gabriella, Sainato, Aldo, Mantello, Giovanna, Dionisi, Francesco, Rosetto, Maria Elena, Fusco, Vincenzo, Navarria, Federico, De Paoli, Antonino, Guido, Alessandra, Vecchi, Claudio, Basilico, Raffaella, Cianci, Roberta, Delli Pizzi, Andrea, Di Nicola, Marta, Mattiucci, Gian Carlo, Valentini, Vincenzo, Morganti, Alessio Giuseppe, Genovesi, Domenico
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container_issue 4
container_start_page 439
container_title Acta oncologica
container_volume 58
creator Caravatta, Luciana
Cellini, Francesco
Simoni, Nicola
Rosa, Consuelo
Niespolo, Rita Marina
Lupattelli, Marco
Picardi, Vincenzo
Macchia, Gabriella
Sainato, Aldo
Mantello, Giovanna
Dionisi, Francesco
Rosetto, Maria Elena
Fusco, Vincenzo
Navarria, Federico
De Paoli, Antonino
Guido, Alessandra
Vecchi, Claudio
Basilico, Raffaella
Cianci, Roberta
Delli Pizzi, Andrea
Di Nicola, Marta
Mattiucci, Gian Carlo
Valentini, Vincenzo
Morganti, Alessio Giuseppe
Genovesi, Domenico
description 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 
doi_str_mv 10.1080/0284186X.2018.1546899
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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 &lt; .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.</description><identifier>ISSN: 0284-186X</identifier><identifier>EISSN: 1651-226X</identifier><identifier>DOI: 10.1080/0284186X.2018.1546899</identifier><identifier>PMID: 30632876</identifier><language>eng</language><publisher>England: Taylor &amp; Francis</publisher><ispartof>Acta oncologica, 2019-04, Vol.58 (4), p.439-447</ispartof><rights>2019 Acta Oncologica Foundation 2019</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c413t-b24b2eb00b3b0f78f88baafa33d1a20121bc4f1b075d59f71bf9047a3f411cb33</citedby><cites>FETCH-LOGICAL-c413t-b24b2eb00b3b0f78f88baafa33d1a20121bc4f1b075d59f71bf9047a3f411cb33</cites><orcidid>0000-0002-2145-2300 ; 0000-0003-4637-6487 ; 0000-0002-4099-0534 ; 0000-0001-9793-3410 ; 0000-0002-2011-3753 ; 0000-0002-3973-8358 ; 0000-0002-0529-201X ; 0000-0002-1308-0113 ; 0000-0002-6130-0360 ; 0000-0002-9512-8108 ; 0000-0002-9680-776X ; 0000-0003-1748-1931</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.tandfonline.com/doi/pdf/10.1080/0284186X.2018.1546899$$EPDF$$P50$$Ginformaworld$$H</linktopdf><linktohtml>$$Uhttps://www.tandfonline.com/doi/full/10.1080/0284186X.2018.1546899$$EHTML$$P50$$Ginformaworld$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,59647,60436</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30632876$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Caravatta, Luciana</creatorcontrib><creatorcontrib>Cellini, Francesco</creatorcontrib><creatorcontrib>Simoni, Nicola</creatorcontrib><creatorcontrib>Rosa, Consuelo</creatorcontrib><creatorcontrib>Niespolo, Rita Marina</creatorcontrib><creatorcontrib>Lupattelli, Marco</creatorcontrib><creatorcontrib>Picardi, Vincenzo</creatorcontrib><creatorcontrib>Macchia, Gabriella</creatorcontrib><creatorcontrib>Sainato, Aldo</creatorcontrib><creatorcontrib>Mantello, Giovanna</creatorcontrib><creatorcontrib>Dionisi, Francesco</creatorcontrib><creatorcontrib>Rosetto, Maria Elena</creatorcontrib><creatorcontrib>Fusco, Vincenzo</creatorcontrib><creatorcontrib>Navarria, Federico</creatorcontrib><creatorcontrib>De Paoli, Antonino</creatorcontrib><creatorcontrib>Guido, Alessandra</creatorcontrib><creatorcontrib>Vecchi, Claudio</creatorcontrib><creatorcontrib>Basilico, Raffaella</creatorcontrib><creatorcontrib>Cianci, Roberta</creatorcontrib><creatorcontrib>Delli Pizzi, Andrea</creatorcontrib><creatorcontrib>Di Nicola, Marta</creatorcontrib><creatorcontrib>Mattiucci, Gian Carlo</creatorcontrib><creatorcontrib>Valentini, Vincenzo</creatorcontrib><creatorcontrib>Morganti, Alessio Giuseppe</creatorcontrib><creatorcontrib>Genovesi, Domenico</creatorcontrib><title>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</title><title>Acta oncologica</title><addtitle>Acta Oncol</addtitle><description>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 &lt; .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.</description><issn>0284-186X</issn><issn>1651-226X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp9UctqGzEUHUpL46b9hBYtncW40mhe7qrBpIkhIRBSyG6QZq7GKiNpqkeCv72bSrbTZVeXC-fFOVn2meAVwS3-iou2JG39tCowaVekKut2vX6TLUhdkbwo6qe32SJh8gQ6yz449wtjXNCmep-dUVzTom3qRfbnjo0avOyRBWc00z0gqdgo9YiWdw_bC9QbNTMLA3qRfnf4go-fN8qMls27PVpuHi-QMBZJ7cEa7sA-g0VstAAKtEdGoNEa55APKsKezRQUoAEmqYF5aXRkojl62_T2qE8x7DfEkAqTl7nUzksfEpJNMYL2JtiU0Pkw7FHkc9ixSSQjvwN0uX24T45hPsQamfPWpHBR5qBw0Hcfs3eCTQ4-ne559vPH1ePmJr-9v95uLm_zviTU57woeQEcY045Fk0r2pYzJhilA2Gx_YLwvhSE46YaqrVoCBdrXDaMipKQnlN6ni2PurM1v0MM0SnpepgmpsEE1xWkWdOGVLiK0OoI7VNfFkQ32ziH3XcEd2n37nX3Lu3enXaPvC8ni8AVDP9Yr0NHwPcjQOpYiWIvxk5D59l-MlbY2Id0Hf2_x1-NYsTE</recordid><startdate>20190403</startdate><enddate>20190403</enddate><creator>Caravatta, Luciana</creator><creator>Cellini, Francesco</creator><creator>Simoni, Nicola</creator><creator>Rosa, Consuelo</creator><creator>Niespolo, Rita Marina</creator><creator>Lupattelli, Marco</creator><creator>Picardi, Vincenzo</creator><creator>Macchia, Gabriella</creator><creator>Sainato, Aldo</creator><creator>Mantello, Giovanna</creator><creator>Dionisi, Francesco</creator><creator>Rosetto, Maria Elena</creator><creator>Fusco, Vincenzo</creator><creator>Navarria, Federico</creator><creator>De Paoli, Antonino</creator><creator>Guido, Alessandra</creator><creator>Vecchi, Claudio</creator><creator>Basilico, Raffaella</creator><creator>Cianci, Roberta</creator><creator>Delli Pizzi, Andrea</creator><creator>Di Nicola, Marta</creator><creator>Mattiucci, Gian Carlo</creator><creator>Valentini, Vincenzo</creator><creator>Morganti, Alessio Giuseppe</creator><creator>Genovesi, Domenico</creator><general>Taylor &amp; 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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 &lt; .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. 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title 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
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-01T03%3A53%3A00IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Magnetic%20resonance%20imaging%20(MRI)%20compared%20with%20computed%20tomography%20(CT)%20for%20interobserver%20agreement%20of%20gross%20tumor%20volume%20delineation%20in%20pancreatic%20cancer:%20a%20multi-institutional%20contouring%20study%20on%20behalf%20of%20the%20AIRO%20group%20for%20gastrointestinal%20cancers&rft.jtitle=Acta%20oncologica&rft.au=Caravatta,%20Luciana&rft.date=2019-04-03&rft.volume=58&rft.issue=4&rft.spage=439&rft.epage=447&rft.pages=439-447&rft.issn=0284-186X&rft.eissn=1651-226X&rft_id=info:doi/10.1080/0284186X.2018.1546899&rft_dat=%3Cproquest_cross%3E2179371505%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2179371505&rft_id=info:pmid/30632876&rfr_iscdi=true