Hidekazu Tanaka1, Takahiro Yamaguchi1, Kae Hachiya1, Kazuhiro Miwa2, Jun Shinoda2, Masahide Hayashi3, Shinichi Ogawa3, Hironori Nishibori4, Satoshi Goshima1, Masayuki Matsuo1. 1. Department of Radiology, Gifu University Graduate School of Medicine, Yanagido 1-1, Gifu 501-1194, Japan. 2. Department of Neurosurgery, Chubu Medical Centre for Prolonged Traumatic Brain Dysfunction, Shimokobi 630, Kobicho, Minokamo 505-8503, Japan. 3. Department of Radiation Oncology, Kizawa Memorial Hospital, Shimokobi 590, Kobicho, Minokamo 505-8503, Japan. 4. Department of Radiology, Kizawa Memorial Hospital, Shimokobi 590, Kobicho, Minokamo 505-8503, Japan.
Abstract
AIM: To define the optimal margin on MRI scans in the re-radiation planning of recurrent glioblastoma using methionine positron emission tomography (MET-PET). BACKGROUND: It would be very useful if the optimal margin on MRI to cover the uptake area on MET-PET is known. MATERIALS AND METHODS: CT, MRI, and MET-PET were performed separately over the course of 2 weeks. Among the MRI scans, we used the contrast-enhanced T1-weighted images (Gd-MRI) and T2-weighted images (T2-MRI). The Gd-MRI-based clinical target volume (CTV) (CTV-Gd) and the T2-MRI-based CTV (CTV-T2) were defined as the contrast-enhanced area on Gd-MRI and the high intensity area on T2-MRI, respectively. We defined CTV x mm (x = 5, 10, 15, 20) as x mm outside the CTV. MET-PET-based CTV (CTV-MPET) was defined as the area of accumulation of MET-PET. We calculated the sensitivity and specificity of CTV-Gd and CTV-T2 following comparison with CTV-MPET, which served as the gold standard in this study. RESULTS: The sensitivity of CTV-T2 5 mm (98%) was significantly higher than CTV-T2 (87%), and there was no significant difference in the sensitivity between CTV-T2 5 mm and CTV T2 10, 15, or 20 mm. The sensitivity of CTV-Gd 20 mm (97%) was lower than that of CTV-T2 5 mm (98%). CONCLUSIONS: A margin of at least 5 mm around the high intensity area on T2-MRI is necessary in the target volume delineation of recurrent glioblastoma for the coverage of MET-PET findings in re-radiation therapy planning.
AIM: To define the optimal margin on MRI scans in the re-radiation planning of recurrent glioblastoma using methionine positron emission tomography (MET-PET). BACKGROUND: It would be very useful if the optimal margin on MRI to cover the uptake area on MET-PET is known. MATERIALS AND METHODS: CT, MRI, and MET-PET were performed separately over the course of 2 weeks. Among the MRI scans, we used the contrast-enhanced T1-weighted images (Gd-MRI) and T2-weighted images (T2-MRI). The Gd-MRI-based clinical target volume (CTV) (CTV-Gd) and the T2-MRI-based CTV (CTV-T2) were defined as the contrast-enhanced area on Gd-MRI and the high intensity area on T2-MRI, respectively. We defined CTV x mm (x = 5, 10, 15, 20) as x mm outside the CTV. MET-PET-based CTV (CTV-MPET) was defined as the area of accumulation of MET-PET. We calculated the sensitivity and specificity of CTV-Gd and CTV-T2 following comparison with CTV-MPET, which served as the gold standard in this study. RESULTS: The sensitivity of CTV-T2 5 mm (98%) was significantly higher than CTV-T2 (87%), and there was no significant difference in the sensitivity between CTV-T2 5 mm and CTV T2 10, 15, or 20 mm. The sensitivity of CTV-Gd 20 mm (97%) was lower than that of CTV-T2 5 mm (98%). CONCLUSIONS: A margin of at least 5 mm around the high intensity area on T2-MRI is necessary in the target volume delineation of recurrent glioblastoma for the coverage of MET-PET findings in re-radiation therapy planning.
Authors: W J Curran; C B Scott; J Horton; J S Nelson; A S Weinstein; A J Fischbach; C H Chang; M Rotman; S O Asbell; R E Krisch Journal: J Natl Cancer Inst Date: 1993-05-05 Impact factor: 13.506
Authors: Roger Stupp; Monika E Hegi; Warren P Mason; Martin J van den Bent; Martin J B Taphoorn; Robert C Janzer; Samuel K Ludwin; Anouk Allgeier; Barbara Fisher; Karl Belanger; Peter Hau; Alba A Brandes; Johanna Gijtenbeek; Christine Marosi; Charles J Vecht; Karima Mokhtari; Pieter Wesseling; Salvador Villa; Elizabeth Eisenhauer; Thierry Gorlia; Michael Weller; Denis Lacombe; J Gregory Cairncross; René-Olivier Mirimanoff Journal: Lancet Oncol Date: 2009-03-09 Impact factor: 41.316
Authors: L E Gaspar; B J Fisher; D R Macdonald; D V LeBer; E C Halperin; S C Schold; J G Cairncross Journal: Int J Radiat Oncol Biol Phys Date: 1992 Impact factor: 7.038
Authors: Min Young Yoo; Jin Chul Paeng; Gi Jeong Cheon; Dong Soo Lee; June-Key Chung; E Edmund Kim; Keon Wook Kang Journal: Nucl Med Mol Imaging Date: 2015-08-29