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Impact of coronal and sagittal views on lung gross tumor volume delineation.pdf

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Impact of coronal and sagittal views on lung gross tumor volume delineation.pdf

Physica Medica 32 (2016) 1082–1087 Contents lists available at ScienceDirect Physica Medica journal homepage: Original paper Impact of coronal and sagittal views on lung gross tumor volume delineation Isabelle Fitton a, Joop C. Duppen b, Roel J.H.M. Steenbakkers c, Heidi Lotz c, Peter J.C.M. Nowak d,1, Coen R.N. Rasch e, Marcel van Herk f,? a Georges Pompidou European Hospital, Paris, France b The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands c University Medical Center Groningen, Groningen, The Netherlands d ERASMUS University Medical Center, Rotterdam, The Netherlands e Academic Medical Center, Amsterdam, The Netherlands f University of Manchester, c/o Christie Hospital NHS Foundation Trust, Manchester, United Kingdom article info Article history: Received 6 May 2016 Received in Revised form 4 August 2016 Accepted 5 August 2016 Available online 3 September 2016 Keywords: Coronal view Sagittal view Radiotherapy Lung cancer Target delineation Inter-observer variability abstract Background and purpose: To study the impact of coronal and sagittal views (CSV) on the gross tumor volume (GTV) delineation on CT and matched PET/CT scans in non-small cell lung cancer. Material and methods: GTV delineations were performed by 11 experienced radiation oncologists on CT and PET/CT in 22 patients. Two tumor groups were de?ned: Group I: Primary tumors surrounded by lung or visceral pleura, without venous invasion, and without large extensions to the chest wall or the mediastinum. Group II: Tumors invading the hilar region, heart, large vessels, pericardium, and the mediastinum and/or associated with atelectasis. Tumor volumes and inter-observers variations (SD) were calculated and compared according to the use of axial view only (AW), axial/coronal/sagittal views (ACSW) and ACSW/PET (ACSWP). Results: CSV were not frequently used (57.4% out of 242 delineations on CT). For group I, ACSW didn’t improve signi?cantly mean GTVs. SDs were smal