Advertisement

Differences in gross tumor volumes for pancreatic cancer: a comparison of ungated positron emission tomography and contrast-enhanced four-dimensional computed tomography

  • Shigeo TakahashiEmail author
  • Masahide Anada
  • Toshifumi Kinoshita
  • Takamasa Nishide
  • Toru Shibata
Original Article
  • 27 Downloads

Abstract

Purpose

We assessed differences in gross tumor volumes (GTVs) for pancreatic cancer between respiratory-ungated positron emission tomography (3D-PET) and contrast-enhanced four-dimensional computed tomography (CE-4DCT).

Materials and methods

We evaluated the GTVs in 21 patients. The sum of the GTVs, which was individually delineated by observers 1 and 2 on the CE-4DCT images from all respiratory phases, was used as GTV-4DCT. The GTVs on the 3D-PET images were extracted with three thresholds: 20%, 30%, and 40% of maximum activity concentration (GTV-n%). We selected one of the GTV-n%, which mostly resembled GTV-4DCT in size, as GTV-PET. Differences in the GTVs were analyzed.

Results

Median values of GTV-4DCT for observers 1, 2, and GTV-PET were 55.0 mL, 45.7 mL, and 14.6 mL, respectively. GTV-PET was smaller than GTV-4DCT for observers 1 and 2 (p < 0.01 each). Differences of median values of maximum diameters between GTV-4DCT and GTV-PET were 1.7–1.8 cm, 1.4–1.6 cm, and 1.9–2.1 cm in the left–right, anterior–posterior, and craniocaudal directions, respectively.

Conclusion

GTV-PET based on 3D-PET images was smaller than GTV-4DCT for pancreatic cancer. When we refer to 3D-PET images without CE-4DCT images, we need to pay attention to the above-mentioned finding to contour the GTV.

Keywords

Delineation Contouring Ungated 3D-PET 4D-CT 

Notes

Acknowledgements

This study was supported by JSPS KAKENHI (Grant number 15K19798).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical statement

All applicable institutional and national guidelines for the care were followed.

References

  1. 1.
    Kalra MK, Maher MM, Boland GW, Saini S, Fischman AJ. Correlation of positron emission tomography and CT in evaluating pancreatic tumors: technical and clinical implications. Am J Roentgenol. 2003;181:387–93.CrossRefGoogle Scholar
  2. 2.
    Ford EC, Herman J, Yorke E, Wahl RL. 18F-FDG PET/CT for image-guided and intensity-modulated radiotherapy. J Nucl Med. 2009;50:1655–65.CrossRefGoogle Scholar
  3. 3.
    Callahan J, Kron T, Schneider-Kolsky M, Hicks RJ. The clinical significance and management of lesion motion due to respiration during PET/CT scanning. Cancer Imaging. 2011;11:224–36.Google Scholar
  4. 4.
    Kishi T, Matsuo Y, Nakamura A, Nakamoto Y, Itasaka S, Mizowaki T, et al. Comparative evaluation of respiratory-gated and ungated FDG-PET for target volume definition in radiotherapy treatment planning for pancreatic cancer. Radiother Oncol. 2016;120:217–21.CrossRefGoogle Scholar
  5. 5.
    Dalah E, Moraru I, Paulson E, Erickson B, Li XA. Variability of target and normal structure delineation using multimodality imaging for radiation therapy of pancreatic cancer. Int J Radiat Oncol Biol Phys. 2014;89:633–40.CrossRefGoogle Scholar
  6. 6.
    Mochizuki K, Gabata T, Kozaka K, Hattori Y, Zen Y, Kitagawa H, et al. MDCT findings of extrapancreatic nerve plexus invasion by pancreas head carcinoma: correlation with en bloc pathological specimens and diagnostic accuracy. Eur Radiol. 2010;20:1757–67.CrossRefGoogle Scholar
  7. 7.
    Matsumoto S, Mori H, Kiyonaga M, Sai M, Yamada Y, Hijiya N, et al. “Peripancreatic strands appearance” in pancreatic body and tail carcinoma: evaluation by multi-detector CT with pathological correlation. Abdom Imaging. 2012;37:602–8.CrossRefGoogle Scholar
  8. 8.
    Ruf J, Amthauer H, Oettle H, Steinmüller T, Plotkin M, Pelzer U, et al. Role of F18-FDG PET for monitoring of radiochemotherapy—estimation of detectable number of tumour cells. Onkologie. 2004;27:287–90.Google Scholar
  9. 9.
    Deshmukh SD, Willmann JK, Jeffrey RB. Pathways of extrapancreatic perineural invasion by pancreatic adenocarcinoma: evaluation with 3D volume-rendered MDCT imaging. Am J Roentgenol. 2010;194:668–74.CrossRefGoogle Scholar
  10. 10.
    Versteijne E, Gurney-Champion OJ, van der Horst A, Lens E, Kolff MW, Buijsen J, et al. Considerable interobserver variation in delineation of pancreatic cancer on 3DCT and 4DCT: a multi-institutional study. Radiat Oncol. 2017;12:58.CrossRefGoogle Scholar
  11. 11.
    Vinod SK, Jameson MG, Min M, Holloway LC. Uncertainties in volume delineation in radiation oncology: a systematic review and recommendations for future studies. Radiother Oncol. 2016;121:169–79.CrossRefGoogle Scholar

Copyright information

© Japan Radiological Society 2019

Authors and Affiliations

  • Shigeo Takahashi
    • 1
    Email author
  • Masahide Anada
    • 1
  • Toshifumi Kinoshita
    • 1
  • Takamasa Nishide
    • 1
  • Toru Shibata
    • 1
  1. 1.Department of Radiation OncologyKagawa University HospitalMiki-Cho, Kita-GunJapan

Personalised recommendations