Inter-observer Variations of the Tumor Bed Delineation for Patients After Breast Conserving Surgery in Preoperative Magnetic Resonance and Computed Tomography Scan Fusion

Overview

Journal BMC Cancer

Publisher Biomed Central

Specialty Oncology

Date 2021 Jul 21

PMID 34284752

Citations 3

Authors

Jie Jiang

Jinhu Chen

Wanhu Li

Yongqing Li

Yiru Chen

Zicheng Zhang

Chengxin Liu

Dan Han

Hongfu Sun

Baosheng Li

Wei Huang

Affiliations

Soon will be listed here.

Abstract

Purpose: Tumor bed (TB) delineation based on preoperative magnetic resonance imaging (pre-MRI) fused with postoperative computed tomography (post-CT) were compared to post-CT only to define pre-MRI may aid in improving the accuracy of delineation.

Methods And Materials: The pre-MRI imaging of 10 patients underwent radiotherapy (RT) after breast conserving surgery (BCS) were reviewed. Post-CT scans were acquired in the same prone position as pre-MRI. Pre-MRI and post-CT automatically match and then manual alignment was given to enhance fusion consistency. Three radiation oncologists and 2 radiologists delineated the clinical target volume (CTV) for CT-based. The gross target volume (GTV) of pre-MRI-based was determined by the volume of tumor acquired with 6 sequences: T1, T2, T2W-SPAIR, DWI, dyn-eTHRIVE and sdyn-eTHRIVE, expended 10 mm to form the CTV-pre-MRI. Planning target volume (PTV) for each sequence was determined by CTV extended 15 mm, trimmed to 3 mm from skin and the breast-chest wall interface. The variability of the TB delineation were developed as follows: the mean volume, conformity index (CI) and dice coefficient (DC).

Results: The mean volumes of CTV and PTV delineated with CT were all larger than those with pre-MRI. The lower inter-observer variability was observed from PTV, especially in sdyn-eTHRIVE in all sequences. For each sequence of pre-MRI, all DCs were larger than post-CT, and the largest DC was observed by sdyn-eTHRIVE sequence fusion to post-CT. The overlap for PTV was significantly improved in the pre-MRI-based compared with the CT-based.

Conclusions: TB volumes based on pre-MRI were smaller than post-CT with CVS increased. Pre-MRI provided a more precise definition of the TB with observers performed a smaller inter-observer variability than CT. Pre-MRI, especially in sdyn-eTHRIVE sequence, should help in reducing treatment volumes with the improved accuracy of TB delineation of adjuvant RT of breast cancer.

Citing Articles

Interobserver variability of clinical target volume delineation in patients undergoing breast-conserving surgery without surgical clips: a pilot study on preoperative magnetic resonance simulation.

Jiao S, Wang Y, Ma J, Shen J, Zhang X, Zhou B BMC Cancer. 2024; 24(1):1321.

PMID: 39455979 PMC: 11515226. DOI: 10.1186/s12885-024-13076-x.

Target volumes comparison between postoperative simulation magnetic resonance imaging and preoperative diagnostic magnetic resonance imaging for prone breast radiotherapy after breast-conserving surgery.

Jin Y, Zhao C, Wang L, Su Y, Shang D, Li F Cancer Med. 2024; 13(3):e6956.

PMID: 38247382 PMC: 10905334. DOI: 10.1002/cam4.6956.

Breast Radiotherapy after Oncoplastic Surgery-A Multidisciplinary Approach.

Metz G, Snook K, Sood S, Baron-Hay S, Spillane A, Lamoury G Cancers (Basel). 2022; 14(7).

PMID: 35406457 PMC: 8996843. DOI: 10.3390/cancers14071685.

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