Determining the gross tumor volume for hepatocellular carcinoma radiotherapy based on multi-phase contrast-enhanced magnetic resonance imaging

IF 2.7 3区医学 Q3 ONCOLOGY

Clinical and Translational Radiation Oncology Pub Date : 2024-10-22 DOI:10.1016/j.ctro.2024.100877

Kangning Meng , Guanzhong Gong , Rui Liu , Shanshan Du , Ruozheng Wang , Yong Yin

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引用次数: 0

Abstract

Purpose

The aim of this study was to quantitatively analyze of the differences in determining the gross tumor volume (GTV) for hepatocellular carcinoma (HCC) radiotherapy using multi-phase contrast-enhanced magnetic resonance imaging (CE-MRI) and provide a reference for determining the GTV for radiotherapy of HCC.

Methods

This retrospective study analyzed 99 HCC patients (145 lesions) who underwent MR simulation. T₁-weighted imaging (T₁WI), contrast-enhanced T₁WI (CE-T₁WI) at 15 s, 45 s, 75 s, 150 s, and 20 min after contrast agent injection were performed, comprising a total of six imaging sequences. The GTVs identified on different sequences were grouped and fused in various combinations. The internal GTV (IGTV), which was the reference structure, was obtained by the fusion of all six sequences. Mean signal intensity (SI), volume, shape, and fibrous capsule (FC) thickness among GTVs were compared.

Results

(1) The mean SI value of GTV_-T1WI, GTV_-15s-GTV_-20min in patients with transarterial chemoembolization (TACE) was lower by 14.09 % (GTV_-T1WI) to 31.31 % (GTV_-15s) compared with that in patients without TACE. Except for GTV_-T1WI, the differences in SI values between the two groups for other GTVs were statistically significant (p < 0.05). (2) The volumes of GTV_-T1WI, GTV_-15s-GTV_-20min ranged from 32.66-34.99 cm³. The volume differences between GTV_-45s and the other GTVs were statistically significant (p < 0.05), excluding the GTV_-T1WI. (3) Compared with the IGTV, the change trend of GTV volume reduction rate is consistent with that of dice similarity coefficients (DSC). (4) In the CE-T₁WI sequences (except for CE-T₁WI_-15s), FC measurement was possible in 39.31 % of lesions (57/145), with the largest mean thickness observed at 75 s.

Conclusion

Although single-phase CE-MRI introduces uncertainty in HCC GTV determination, combining different phases CE-MRI can enhance accuracy. The CE-T₁WI_-45s should be routinely included as a necessary scanning sequence.

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基于多相对比增强磁共振成像确定肝细胞癌放射治疗的总肿瘤体积

目的本研究旨在定量分析使用多相对比增强磁共振成像（CE-MRI）确定肝细胞癌（HCC）放疗的肿瘤总体积（GTV）的差异，为确定 HCC 放疗的 GTV 提供参考。在注射造影剂后 15 秒、45 秒、75 秒、150 秒和 20 分钟分别进行了 T1 加权成像（T1WI）、造影剂增强 T1WI（CE-T1WI），共六种成像序列。在不同序列上确定的 GTV 被分组并以不同的组合进行融合。通过融合所有六个序列得到内部 GTV（IGTV），作为参考结构。结果(1) 经动脉化疗栓塞（TACE）患者的 GTV-T1WI、GTV-15s-GTV-20min 的平均信号强度（SI）值比未进行 TACE 的患者低 14.09 %（GTV-T1WI）至 31.31 %（GTV-15s）。除 GTV-T1WI 外，两组其他 GTV 的 SI 值差异均有统计学意义（P < 0.05）。(2）GTV-T1WI、GTV-15s-GTV-20min 的体积范围为 32.66-34.99 立方厘米。除 GTV-T1WI 外，GTV-45s 与其他 GTV 的体积差异有统计学意义（P < 0.05）。(3）与 IGTV 相比，GTV 体积缩小率的变化趋势与骰子相似系数（DSC）的变化趋势一致。(4）在 CE-T1WI 序列中（CE-T1WI-15s 除外），39.31% 的病灶（57/145）可进行 FC 测量，75 s 时观察到的平均厚度最大。CE-T1WI-45s 应作为必要的常规扫描序列。

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来源期刊

Clinical and Translational Radiation Oncology Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

5.30

自引率

3.20%

发文量

114

审稿时长

40 days