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Target Volume Delineation Based on Diffusion-weighted magnetic Resonance Imaging for Locally Advanced Head and Neck
Francesca DE Felice1, Daniela Musio2, Nadia Bulzonetti2
1Department of Radiotherapy, Policlinico Umberto I "Sapienza" University of Rome, Rome, Italy fradefelice@hotmail.it.
Aim:
To compare gross tumor volume (GTV) definition in locally advanced head and neck squamous cell carcinoma (LAHNSCC) using diffusion-weighted magnetic resonance imaging (DW-MRI) and computed tomography (CT) with intravenous contrast.
Patients And Methods:
Patients with LAHNSCC were imaged with CT and DW-MRI before treatment. GTV was delineated in both CT and DW-MRI images by two investigators. CT and MRI images were co-registered and volume data were extracted for statistical analysis.
Results:
In general, DW-MRI volumes [based on the apparent diffusion coefficient (ADC)] were smaller than CT-based volumes. For all patients, GTV delineation based on pre-treatment DW-MRI was significantly smaller than that based on CT scan (CT-GTV) (p=0.0078). The mean difference (95% limits of agreement) between the two investigators was -0.37 cm(3) for CT-GTV and 0.17 cm(3) for ADC-GTV measurements, respectively.
Conclusion:
DW-MRI radiotherapy GTVs are smaller than CT-based targets with less interobserver variability. Further validation of these preliminary results is necessary in a much larger patient group.
