TITLE

Impact of FDG-PET/CT Fused Imaging on Tumor Volume Assessment of Head-and-Neck Squamous Cell Carcinoma: Intermethod and Interobserver Variations

AUTHOR(S)
Murakami, R.; Uozumi, H.; Hirai, T.; Nishimura, R.; Katsuragawa, S.; Shiraishi, S.; Toya, R.; Tashiro, K.; Kawanaka, K.; Oya, N.; Tomiguchi, S.; Yamashita, Y.
PUB. DATE
August 2008
SOURCE
Acta Radiologica;Aug2008, Vol. 49 Issue 6, p693
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Although gross tumor volume (GTV) at the primary site can predict local control of head-and-neck squamous cell carcinoma (SCC) in patients who are treated with organ-preservation therapy, GTV assessment does not eliminate substantial interobserver variation. Purpose: To evaluate whether F-18-fluorodeoxyglucose positron emission tomography (FDG-PET)/computed tomography (CT) fused imaging provides additional information for GTV assessment. Material and Methods: We obtained FDG-PET/CT fused images on 20 patients with head-and-neck SCC. All had undergone preoperative conventional workup, including contrast-enhanced CT and magnetic resonance imaging (MRI). The GTV of the primary tumors was designed by two independent observers who used routine clinical data. Observer A was a radiologist and observer B a radiation oncologist. GTV1 and GTV2 were designed without and with FDG-PET/CT, respectively. For geometric interobserver comparison, we calculated the concordance rate as the ratio of the intersection (Ax∩B) of the GTVs to their union (Ax∪B). Intermethod (GTV1 vs. GTV2) and interobserver (A vs. B) differences in the GTVs were assessed by Bland-Altman analysis and the Spearman rank-correlation test. The interobserver concordance rates for GTV1 and GTV2 were compared using a two-tailed paired-samples t test. Results: On FDG-PET/CT, all primary tumors were visualized. There was no systemic trend for a volume difference between GTV1 and GTV2. Although the 95% limits of agreement were wider for interobserver than intermethod differences, the 95% limits of interobserver agreement were narrower for GTV2 than GTV1. The mean interobserver concordance rate for GTV2 was higher than for GTV1 (54.5% vs. 39.1%, P=0.0002). Conclusion: FDG-PET/CT is a useful modality for consistent GTV assessment, which should not be used as a single modality but rather to obtain supplemental information in patients with head-and-neck SCC.
ACCESSION #
32718502

 

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