Abstract
BackgroundClinically, many esophageal cancer patients who planned for radiation therapy have already undergone diagnostic Positron-emission tomography/computed tomography (PET/CT) imaging, but it remains unclear whether these imaging results can be used to delineate the gross target volume (GTV) of the primary tumor for thoracic esophageal cancer (EC).MethodsSeventy-two patients diagnosed with thoracic EC had undergone prior PET/CT for diagnosis and three-dimensional CT (3DCT) for simulation. The GTV3D was contoured on the 3DCT image without referencing the PET/CT image. The GTVPET-ref was contoured on the 3DCT image referencing the PET/CT image. The GTVPET-reg was contoured on the deformed registration image derived from 3DCT and PET/CT. Differences in the position, volume, length, conformity index (CI), and degree of inclusion (DI) among the target volumes were determined.ResultsThe centroid distance in the three directions between two different GTVs showed no significant difference (P > 0.05). No significant difference was found among the groups in the tumor volume (P > 0.05). The median DI values of the GTVPET-reg and GTVPET-ref in the GTV3D were 0.82 and 0.86, respectively (P = 0.006). The median CI values of the GTV3D in the GTVPET-reg and GTVPET-ref were 0.68 and 0.72, respectively (P = 0.006).ConclusionsPET/CT can be used to optimize the definition of the target volume in EC. However, no significant difference was found between the GTVs delineated based on visual referencing or deformable registration whether using the volume or position. So, in the absence of planning PET–CT images, it is also feasible to delineate the GTV of primary thoracic EC with reference to the diagnostic PET–CT image.
Highlights
According to the newly published GLOBOCAN 2018 study [1], esophageal cancer ranks seventh in cancer incidence and sixth in cancer mortality, with 572,000 new esophageal cancer cases and 590,000 deaths
The present study aimed to evaluate geometrical differences in the gross tumor volume (GTV) contoured on planning CT, referencing Positron-emission tomography/computed tomography (PET/CT) and the GTV contoured on the deformed image derived from planning CT and PET/CT for primary thoracic esophageal cancer (EC)
To investigate the correlation between different locations of EC and changes in position, the patients were divided into three groups according to the 2007 Tumor Node Metastasis (TNM) classification system of the National Comprehensive Cancer Network (NCCN): group A: 32 patients with lesions located in the proximal segment; group B: 24 patients with lesions located in the middle segment; group C: 16 patients with lesions located in the distal segment
Summary
According to the newly published GLOBOCAN 2018 study [1], esophageal cancer ranks seventh in cancer incidence and sixth in cancer mortality, with 572,000 new esophageal cancer cases and 590,000 deaths. Jin et al [10] integrate the RTCT and PET modalities together into a two-stream chained deep fusion framework, which represents a complete workflow for the target delineation in esophageal cancer radiotherapy and pushes forward the state of automated esophageal GTV and CTV segmentation towards a clinically applicable solution. Using extensive five-fold cross-validation on 110 esophageal cancer patients, they demonstrate that both the proposed two-stream chained segmentation pipeline that effectively fuses the CT and PET modalities via early and late 3D deep-network-based fusion and the PSNN model can significantly improve the accurate GTV segmentation over the previous state-of-the-art work [11]. Many esophageal cancer patients who planned for radiation therapy have already undergone diagnostic Positron-emission tomography/computed tomography (PET/CT) imaging, but it remains unclear whether these imaging results can be used to delineate the gross target volume (GTV) of the primary tumor for thoracic esophageal cancer (EC)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
