MRI and CT imaging for preoperative target volume delineation in breast-conserving therapy

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• 作者：Mariska D den Hartogh (5)
  Marielle EP Philippens (5)
  Iris E van Dam (5)
  Catharina E Kleynen (5)
  Robbert JHA Tersteeg (5)
  Ruud M Pijnappel (6)
  Alexis NTJ Kotte (5)
  Helena M Verkooijen (5) (6)
  Maurice AAJ van den Bosch (6)
  Marco van Vulpen (5)
  Bram van Asselen (5)
  HJG Desirée van den Bongard (5)
  
• 关键词：MRI ; CT ; Supine ; Interobserver variability ; Preoperative ; GTV ; Tumor bed ; Breast cancer ; Radiotherapy
• 刊名：Radiation Oncology
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：9
• 期：1
• 全文大小：794 KB
• 参考文献：1. Darby S, McGale P, Correa C, Taylor C, Arriagada R, Clarke M, Cutter D, Davies C, Ewertz M, Godwin J, Gray R, Pierce L, Whelan T, Wang Y, Peto R, Early Breast Cancer Trialists-Collaborative Group (EBCTCG): Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10,801 women in 17 randomised trials. / Lancet 2011, 378:1707-716. CrossRef
  2. Bartelink H, Horiot JC, Poortmans PM, Struikmans H, Van den Bogaert W, Fourquet A, Jager JJ, Hoogenraad WJ, Oei SB, Warlam-Rodenhuis CC, Pierart M, Collette L: Impact of a higher radiation dose on local control and survival in breast-conserving therapy of early breast cancer: 10-year results of the randomized boost versus no boost EORTC 22881-0882 trial. / J Clin Oncol 2007, 25:3259-265. CrossRef
  3. Theberge V, Whelan T, Shaitelman SF, Vicini FA: Altered fractionation: rationale and justification for whole and partial breast hypofractionated radiotherapy. / Semin Radiat Oncol 2011, 21:55-5. CrossRef
  4. Struikmans H, Warlam-Rodenhuis C, Stam T, Stapper G, Tersteeg RJ, Bol GH, Raaijmakers CP: Interobserver variability of clinical target volume delineation of glandular breast tissue and of boost volume in tangential breast irradiation. / Radiother Oncol 2005, 76:293-99. CrossRef
  5. Petersen RP, Truong PT, Kader HA, Berthelet E, Lee JC, Hilts ML, Kader AS, Beckham WA, Olivotto IA: Target volume delineation for partial breast radiotherapy planning: clinical characteristics associated with low interobserver concordance. / Int J Radiat Oncol Biol Phys 2007, 69:41-8. CrossRef
  6. Hurkmans C, Admiraal M, van der Sangen M, Dijkmans I: Significance of breast boost volume changes during radiotherapy in relation to current clinical interobserver variations. / Radiother Oncol 2009, 90:60-5. CrossRef
  7. Coles CE, Wilson CB, Cumming J, Benson JR, Forouhi P, Wilkinson JS, Jena R, Wishart GC: Titanium clip placement to allow accurate tumour bed localisation following breast conserving surgery: audit on behalf of the IMPORT Trial Management Group. / Eur J Surg Oncol 2009, 35:578-82. CrossRef
  8. Jolicoeur M, Racine ML, Trop I, Hathout L, Nguyen D, Derashodian T, David S: Localization of the surgical bed using supine magnetic resonance and computed tomography scan fusion for planification of breast interstitial brachytherapy. / Radiother Oncol 2011, 100:480-84. CrossRef
  9. Giezen M, Kouwenhoven E, Scholten AN, Coerkamp EG, Heijenbrok M, Jansen WP, Mast ME, Petoukhova AL, Struikmans H: MRI- versus CT-based volume delineation of lumpectomy cavity in supine position in breast-conserving therapy: an exploratory study. / Int J Radiat Oncol Biol Phys 2012, 82:1332-340. CrossRef
  10. van Mourik AM, Elkhuizen PH, Minkema D, Duppen JC, van Vliet-Vroegindeweij C, Dutch Young Boost Study Group: Multiinstitutional study on target volume delineation variation in breast radiotherapy in the presence of guidelines. / Radiother Oncol 2010, 94:286-91. CrossRef
  11. Boersma LJ, Janssen T, Elkhuizen PH, Poortmans P, van der Sangen M, Scholten AN, Hanbeukers B, Duppen JC, Hurkmans C, van Vliet C: Reducing interobserver variation of boost-CTV delineation in breast conserving radiation therapy using a pre-operative CT and delineation guidelines. / Radiother Oncol 2012, 103:178-82. CrossRef
  12. van den Assem MB, Visser J, Zonderland HM, van Tienhoven G, Crama KF, Bijker N: 459 pre-operative CT scan in breast conserving therapy for determination of the boost volume for radiotherapy. / Eur J Cancer 2012,48(Supplement 1):S180-S181. CrossRef
  13. Landis DM, Luo W, Song J, Bellon JR, Punglia RS, Wong JS, Killoran JH, Gelman R, Harris JR: Variability among breast radiation oncologists in delineation of the postsurgical lumpectomy cavity. / Int J Radiat Oncol Biol Phys 2007, 67:1299-308. CrossRef
  14. Vrieling C, Collette L, Fourquet A, Hoogenraad WJ, Horiot JH, Jager JJ, Pierart M, Poortmans PM, Struikmans H, Maat B, Van Limbergen E, Bartelink H: The influence of patient, tumor and treatment factors on the cosmetic results after breast-conserving therapy in the EORTC ‘boost vs. no boost-trial. EORTC Radiotherapy and Breast Cancer Cooperative Groups. / Radiother Oncol 2000, 55:219-32. CrossRef
  15. Collette S, Collette L, Budiharto T, Horiot JC, Poortmans PM, Struikmans H, Van den Bogaert W, Fourquet A, Jager JJ, Hoogenraad W, Mueller RP, Kurtz J, Morgan DA, Dubois JB, Salamon E, Mirimanoff R, Bolla M, Van der Hulst M, Warlam-Rodenhuis CC, Bartelink H, EORTC Radiation Oncology Group: Predictors of the risk of fibrosis at 10 years after breast conserving therapy for early breast cancer: a study based on the EORTC Trial 22881-0882 ‘boost versus no boost- / Eur J Cancer 2008, 44:2587-599. CrossRef
  16. Benda RK, Yasuda G, Sethi A, Gabram SG, Hinerman RW, Mendenhall NP: Breast boost: are we missing the target? / Cancer 2003, 97:905-09. CrossRef
  17. den Hartogh MD, van Asselen B, Monninkhof EM, van den Bosch MA, van Vulpen M, van Diest PJ, Gilhuijs KG, Witkamp AJ, van de Bunt L, Mali WP, van den Bongard HJ: Excised and irradiated volumes in relation to the tumor size in breast-conserving therapy. / Breast Cancer Res Treat 2011, 129:857-65. CrossRef
  18. Nichols EM, Feigenberg SJ, Marter K, Cheston SB, Lasio G, Tkaczuk K, Kesmodel S, Buras R, Regine WF: Preoperative radiation therapy significantly increases patient eligibility for accelerated partial breast irradiation using 3D-conformal radiotherapy. / Am J Clin Oncol 2012, 36:232-38. CrossRef
  19. Pignol JP, Rakovitch E, Keller BM, Sankreacha R, Chartier C: Tolerance and acceptance results of a palladium-103 permanent breast seed implant phase I/II study. / Int J Radiat Oncol Biol Phys 2009, 73:1482-488. CrossRef
  20. van der Leij F, Elkhuizen PHM, Janssen TM, Poortmans P, van der Sangen M, Scholten AN, van Vliet-Vroegindeweij C, Boersma LJ: External beam partial breast irradiation: difference in pre- and postoperative target volume delineation. / Radiother Oncol 2012,103(Supplement 1):S246. CrossRef
  21. Palta M, Yoo S, Adamson JD, Prosnitz LR, Horton JK: Preoperative single fraction partial breast radiotherapy for early-stage breast cancer. / Int J Radiat Oncol Biol Phys 2012, 82:37-2. CrossRef
  22. Kim L, Shaitelman S: What is the target volume for preoperative accelerated partial breast irradiation (APBI)? In regards to Nichols et al. (Int J Radiat Oncol Biol Phys 2010;77:197-02) and Palta et al. (Int J Radiat Oncol Biol Phys 2010, in Press). / Int J Radiat Oncol Biol Phys 2011, 80:314-15. author reply 315-16 CrossRef
  23. Bondiau PY, Courdi A, Bahadoran P, Chamorey E, Queille-Roussel C, Lallement M, Birtwisle-Peyrottes I, Chapellier C, Pacquelet-Cheli S, Ferrero JM: Phase 1 clinical trial of stereotactic body radiation therapy concomitant with neoadjuvant chemotherapy for breast cancer. / Int J Radiat Oncol Biol Phys 2013, 85:1193-199. CrossRef
  24. Schmitz AC, van den Bosch MA, Loo CE, Mali WP, Bartelink H, Gertenbach M, Holland R, Peterse JL, Rutgers EJ, Gilhuijs KG: Precise correlation between MRI and histopathology - exploring treatment margins for MRI-guided localized breast cancer therapy. / Radiother Oncol 2010, 97:225-32. CrossRef
  25. Peters NH, Borel Rinkes IH, Zuithoff NP, Mali WP, Moons KG, Peeters PH: Meta-analysis of MR imaging in the diagnosis of breast lesions. / Radiology 2008, 246:116-24. CrossRef
  26. Kuroki-Suzuki S, Kuroki Y, Ishikawa T, Takeo H, Moriyama N: Diagnosis of breast cancer with multidetector computed tomography: analysis of optimal delay time after contrast media injection. / Clin Imaging 2010, 34:14-9. CrossRef
  27. Ikeda DM, Hylton NM, Kinkel K, Hochman MG, Kuhl CK, Kaiser WA, Weinreb JC, Smazal SF, Degani H, Viehweg P, Barclay J, Schnall MD: Development, standardization, and testing of a lexicon for reporting contrast-enhanced breast magnetic resonance imaging studies. / J Magn Reson Imaging 2001, 13:889-95. CrossRef
  28. Bol GH, Kotte AN, van der Heide UA, Lagendijk JJ: Simultaneous multi-modality ROI delineation in clinical practice. / Comput Methods Programs Biomed 2009, 96:133-40. CrossRef
  29. Kouwenhoven E, Giezen M, Struikmans H: Measuring the similarity of target volume delineations independent of the number of observers. / Phys Med Biol 2009, 54:2863-873. CrossRef
  30. Lagendijk JJ, Raaymakers BW, Raaijmakers AJ, Overweg J, Brown KJ, Kerkhof EM, van der Put RW, Hardemark B, van Vulpen M, van der Heide UA: MRI/linac integration. / Radiother Oncol 2008, 86:25-9. CrossRef
  31. Tersteeg RJ, Roesink JM, Albregts M, Warlam-Rodenhuis CC, van Asselen B: Changes in excision cavity volume: prediction of the reduction in absolute volume during breast irradiation. / Int J Radiat Oncol Biol Phys 2009, 74:1181-185. CrossRef
  32. van Heijst TC, den Hartogh MD, Lagendijk JJ, van den Bongard HJ, van Asselen B: MR-guided breast radiotherapy: feasibility and magnetic-field impact on skin dose. / Phys Med Biol 2013, 58:5917-930. CrossRef
  33. Alderliesten T, Loo C, Paape A, Muller S, Rutgers E, Peeters MJ, Gilhuijs K: On the feasibility of MRI-guided navigation to demarcate breast cancer for breast-conserving surgery. / Med Phys 2010, 37:2617-626. CrossRef
  
• 作者单位：Mariska D den Hartogh (5)
  Marielle EP Philippens (5)
  Iris E van Dam (5)
  Catharina E Kleynen (5)
  Robbert JHA Tersteeg (5)
  Ruud M Pijnappel (6)
  Alexis NTJ Kotte (5)
  Helena M Verkooijen (5) (6)
  Maurice AAJ van den Bosch (6)
  Marco van Vulpen (5)
  Bram van Asselen (5)
  HJG Desirée van den Bongard (5)
  
  5. Department of Radiotherapy, University Medical Center Utrecht, HP Q00.118, PO Box 85500, 3508 GA, Utrecht, The Netherlands
  6. Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
  
• ISSN：1748-717X

文摘

Background Accurate tumor bed delineation after breast-conserving surgery is important. However, consistency among observers on standard postoperative radiotherapy planning CT is low and volumes can be large due to seroma formation. A preoperative delineation of the tumor might be more consistent. Therefore, the purpose of this study was to determine the consistency of preoperative target volume delineation on CT and MRI for breast-conserving radiotherapy. Methods Tumors were delineated on preoperative contrast-enhanced (CE) CT and newly developed 3D CE-MR images, by four breast radiation oncologists. Clinical target volumes (CTVs) were created by addition of a 1.5?cm margin around the tumor, excluding skin and chest wall. Consistency in target volume delineation was expressed by the interobserver variability. Therefore, the conformity index (CI), center of mass distance (dCOM) and volumes were calculated. Tumor characteristics on CT and MRI were scored by an experienced breast radiologist. Results Preoperative tumor delineation resulted in a high interobserver agreement with a high median CI for the CTV, for both CT (0.80) and MRI (0.84). The tumor was missed on CT in 2/14 patients (14%). Leaving these 2 patients out of the analysis, CI was higher on MRI compared to CT for the GTV (p-lt;-.001) while not for the CTV (CT (0.82) versus MRI (0.84), p--.123). The dCOM did not differ between CT and MRI. The median CTV was 48?cm3 (range 28-37?cm3) on CT and 59?cm3 (range 30-53?cm3) on MRI (p-lt;-.001). Tumor shapes and margins were rated as more irregular and spiculated on CE-MRI. Conclusions This study showed that preoperative target volume delineation resulted in small target volumes with a high consistency among observers. MRI appeared to be necessary for tumor detection and the visualization of irregularities and spiculations. Regarding the tumor delineation itself, no clinically relevant differences in interobserver variability were observed. These results will be used to study the potential for future MRI-guided and neoadjuvant radiotherapy. Trial registration International Clinical Trials Registry Platform NTR3198.