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Inter-observer variation in gross tumour volume delineation of oesophageal cancer on MR, CT and PET/CT

Ajra Secerov-Ermenc

Ajra Secerov-Ermenc

  • Department of Radiation Oncology, Institute of Oncology LjubljanaLjubljana, Slovenia
  • Faculty of Medicine, University of LjubljanaLjubljana, Slovenia
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Secerov-Ermenc, Ajra
, 
Primoz Peterlin

Primoz Peterlin

Department of Radiation Oncology, Institute of Oncology LjubljanaLjubljana, Slovenia
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Peterlin, Primoz
, 
Franc Anderluh

Franc Anderluh

Department of Radiation Oncology, Institute of Oncology LjubljanaLjubljana, Slovenia
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Anderluh, Franc
, 
Jasna But-Hadzic

Jasna But-Hadzic

  • Department of Radiation Oncology, Institute of Oncology LjubljanaLjubljana, Slovenia
  • Faculty of Medicine, University of LjubljanaLjubljana, Slovenia
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But-Hadzic, Jasna
, 
Ana Jeromen-Peressutti

Ana Jeromen-Peressutti

Department of Radiation Oncology, Institute of Oncology LjubljanaLjubljana, Slovenia
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Jeromen-Peressutti, Ana
, 
Vaneja Velenik

Vaneja Velenik

  • Department of Radiation Oncology, Institute of Oncology LjubljanaLjubljana, Slovenia
  • Faculty of Medicine, University of LjubljanaLjubljana, Slovenia
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Velenik, Vaneja
 and 
Barbara Segedin

Barbara Segedin

  • Department of Radiation Oncology, Institute of Oncology LjubljanaLjubljana, Slovenia
  • Faculty of Medicine, University of LjubljanaLjubljana, Slovenia
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Segedin, Barbara
  
Oct 04, 2024
Inter-observer variation in gross tumour volume delineation of oesophageal cancer on MR, CT and PET/CT's Cover Image
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Article Category: Research Article
Published Online: Oct 04, 2024
Page range: 580 - 587
Received: May 11, 2024
Accepted: Jul 25, 2024
DOI: https://doi.org/10.2478/raon-2024-0043
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© 2024 Ajra Secerov-Ermenc et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.

FIGURE 1.

The coordinate system for spatial assessment of inter-delineation distances is projected on a single slice of imaging modality containing an example of GTV and divided in 12 angular segments (6 on the left and 6 on the right). Green line represents the reference contour, red line is the test contour.
The coordinate system for spatial assessment of inter-delineation distances is projected on a single slice of imaging modality containing an example of GTV and divided in 12 angular segments (6 on the left and 6 on the right). Green line represents the reference contour, red line is the test contour.

FIGURE 2.

Mean planar conformity index (PCI) for the GTV as a function of slice number for all imaging modalities for case 22.Blue = computed tomography (CT); Green = fusion of PET/CT and MR; Red = magnetic resonance imaging (MR); Violet = positron emission tomography and CT (PET/CT); Yellow = fusion of CT and MR (CT MR); 1= most caudal slice; 33= most cranial slice.
Mean planar conformity index (PCI) for the GTV as a function of slice number for all imaging modalities for case 22.Blue = computed tomography (CT); Green = fusion of PET/CT and MR; Red = magnetic resonance imaging (MR); Violet = positron emission tomography and CT (PET/CT); Yellow = fusion of CT and MR (CT MR); 1= most caudal slice; 33= most cranial slice.

FIGURE 3.

Delineation of the gross tumour volume (GTV) of all five observers of case 22, sagittal view. The variation in cranial border is highest on computed tomography (CT) and lowest on positron emission tomography (PET/CT) magnetic resonance (MR).(A) CT; (B) PET/CT; (C) fusion of CT and MR; (D) fusion of PET/CT and MR.
Delineation of the gross tumour volume (GTV) of all five observers of case 22, sagittal view. The variation in cranial border is highest on computed tomography (CT) and lowest on positron emission tomography (PET/CT) magnetic resonance (MR).(A) CT; (B) PET/CT; (C) fusion of CT and MR; (D) fusion of PET/CT and MR.

FIGURE 4.

Mean inter-delineation distance (IDD) curves of the gross tumour volume (GTV) delineated on different imaging modalities as a function of the angle. The IDD is largest in tumours of the lower third and similar in upper and thirds. (A) Upper third of the oesophagus; (B) Middle third of the oesophagus; (C) Lower third of the oesophagus.Blue = computed tomography; Green = fusion of PET CT and MR. Red = magnetic resonance imaging; Violet = positron emission tomography and CT; Yellow = fusion of CT and MR
Mean inter-delineation distance (IDD) curves of the gross tumour volume (GTV) delineated on different imaging modalities as a function of the angle. The IDD is largest in tumours of the lower third and similar in upper and thirds. (A) Upper third of the oesophagus; (B) Middle third of the oesophagus; (C) Lower third of the oesophagus.Blue = computed tomography; Green = fusion of PET CT and MR. Red = magnetic resonance imaging; Violet = positron emission tomography and CT; Yellow = fusion of CT and MR

Mean volume of gross tumor volume (GTV), CIgen, VCI, PCI, IDD and standard deviation

CT (SD) MR (SD) CT MR (SD) PET/CT (SD) PET/CT MR (SD)
Volume (cm3) 37.14 (35.66) 33.03 (30.40) 35.04 (32.58) 44.12 (39.10) 40.94 (35.16)
CIgen 0.56 (0.18) 0.61 (0.14) 0.61 (0.14) 064 (0.13) 0.67 (0.12)
VCI 0.67 (0.18) 0.71 (0.15) 0.71 (0.14) 0.74 (0.14) 0.77 (0.12)
PCI 0.64 (0.17) 0.67 (0.16) 0.67 (0.15) 0.71 (0.14) 0.73 (0.13)
IDD (mm) 1.39 (1.47) 1.44 (1.44) 1.70 (1.50) 1.68 (1.50) 1.60 (1.66)

Characteristics of the patients with oesophageal cancer enrolled in the study

Case Location – third Histology Treatment Stage Gender Age
1 Proximal SCC definitive T3N0M0 M 62
2 Proximal SCC definitive T3N0M0 M 66
3 Distal AC preoperative T3N1M0 M 64
4 Middle SCC definitive T3N1M0 M 68
5 Proximal SCC definitive T3N2M0 F 60
6 Proximal SCC definitive T3N1M0 M 57
7 Distal AC preoperative T3N1M0 M 66
8 Proximal SCC definitive T3N1M0 M 64
9 Distal AC definitive T2N0M0 M 81
10 Distal AC preoperative T3N2M0 M 35
11 Proximal SCC definitive T3N0M0 M 58
12 Distal SCC preoperative T3N1M0 M 61
13 Proximal SCC definitive T3N0M0 M 63
14 Middle SCC preoperative T3N0M0 M 54
15 Distal AC preoperative T3N0M0 M 64
16 Middle SCC definitive T3N1M0 F 83
17 Distal AC preoperative T3N1M0 M 58
18 Proximal SCC definitive T3N0M0 M 42
19 Distal AC preoperative T3N0M0 M 75
20 Proximal SCC definitive T3N0M0 M 70
21 Proximal SCC definitive T3N2M0 F 46
22 Middle SCC preoperative T3N0M0 M 53
23 Middle SCC preoperative T2N2M0 M 67
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