A comparative study of target volumes based on deformation registration using preoperative prone magnetic resonance imaging and postoperative prone computed tomography imaging for patients undergoing breast-conserving surgery
10.3760/cma.j.issn.0254-5098.2018.07.004
- VernacularTitle: 保乳患者术前诊断MRI与术后俯卧位定位CT基于形变配准的靶区比较研究
- Author:
Ting YU
1
;
Jianbin LI
2
;
Wei WANG
2
;
Min XU
2
;
Qian SHAO
2
;
Yingjie ZHANG
2
;
Xijun LIU
2
Author Information
1. School of Medicine and Life Sciences, University of Jinan, Shandong Academy of Medical Sciences, Jinan 250022, China
2. Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Jinan 250117, China
- Publication Type:Journal Article
- Keywords:
Preoperative diagnostic magnetic resonance image;
Postoperative prone computed tomography simulation image;
Deformable image registration;
Target volume comparison;
External-beam partial breast irradiation
- From:
Chinese Journal of Radiological Medicine and Protection
2018;38(7):499-504
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the differences and correlation between the target volumes based on deformation registration (DIR) using preoperative prone diagnostic magnetic resonance (MR) imaging and postoperative prone computed tomography (CT) simulation imaging for patients undergoing breast-conserving surgery (BCS).
Methods:Eighteen breast cancer patients suitable for external-beam partial breast irradiation (EB-PBI) after BCS were enrolled. Preoperative prone diagnostic MR and postoperative prone CT scan sets were acquired during free breathing for all patients. The gross tumor volume (GTV) delineated on the preoperative diagnostic MR images was defined as GTVMRI, the clinical target volumes (CTVMRI+ 1 and CTVMRI+ 2)were defined as 10 and 20 mm margins around the GTVMRI, and the planning target volume (PTVMRI+ 1 and PTVMRI+ 2) were defined as 15 and 25 mm margins around the GTVMRI, respectively. Tumor bed (TB) delineated on the postoperative prone CT simulation images acquired during free breathing was defined as GTVTB, CTV and PTV were defined as 10 and 15 mm margins around the GTVTB, respectively. The target volume of the whole breast contoured on the MR and CT images were defined as CTVBreast-MRI and CTVBreast-CI, respectively. The MR and CT images were registered deformably in MIM software system.
Results:The GTVTB, CTVTB and PTVTB were significantly greater than GTVMRI, GTVMRI+ 1 and PTVMRI+ 1, respectively (Z=-3.593, -3.593, -2.983, P<0.05). Meanwhile, the CTVTB and PTVTB were significantly less than the CTVMRI+ 2 and PTVMRI+ 2, respectively(Z=-2.722, -2.853, P<0.05). The conformal index (CI) and degree of inclusion (DI) of GTVTB-GTVMRI, GTVTB-CTVMRI+ 1, CTVTB-GTVMRI and CTVTB-GTVMRI+ 1 based on center-coincidence of the compared targets were better than those based on DIR of the thorax(Z=-3.724、-3.724、-2.591、-3.593, P<0.05; Z=-3.724、-3.724、-3.201、-3.724, P<0.05).
Conclusions:For the patients enrolled for prone EB-PBI, target volumes delineated on the preoperative prone MR images were significantly smaller compared to that on the postoperative prone CT images, but a statistically significant positive correlation was found between the MR and CT target volumes. There were still relatively poor spatial overlap whether for the whole breast or the targets between the preoperative prone diagnostic MR images and the postoperative prone simulation CT images based on DIR. Therefore, it is infeasible to guide postoperative EB-PBI target delineation using the preoperative prone diagnostic MR images.
