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    Head and Neck Imaging

    Tumor Volume in Pharyngolaryngeal Squamous Cell Carcinoma: Comparison at CT, MR Imaging, and FDG PET and Validation with Surgical Specimen

    Published Online:Oct 1 2004https://doi.org/10.1148/radiol.2331030660

    Abstract

    PURPOSE: To compare computed tomography (CT), magnetic resonance (MR) imaging, and fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET) for delineation of gross tumor volume (GTV) in pharyngolaryngeal squamous cell carcinoma and to validate results with the macroscopic surgical specimen when available.

    MATERIALS AND METHODS: Twenty-nine patients with stages II–IV squamous cell carcinoma treated with radiation therapy or chemotherapy and radiation therapy (n = 20) or with total laryngectomy (n = 9) were enrolled. Ten patients had oropharyngeal, 13 had laryngeal, and six had hypopharyngeal tumors. CT, MR imaging, and PET were performed with patients immobilized in a customized thermoplastic mask, and images were coregistered. GTVs obtained with the three modalities were compared quantitatively and qualitatively. If patients underwent total laryngectomy, images were validated with the surgical specimen after three-dimensional coregistration. The effect of each modality was estimated with linear mixed-effects models. Adjustments for multiple comparisons were made with the Bonferonni or Sidak method.

    RESULTS: For oropharyngeal tumors and for laryngeal or hypopharyngeal tumors, no significant difference (P > .99) was observed between average GTVs delineated at CT (32.0 and 21.4 cm3, respectively) or MR imaging (27.9 and 21.4 cm3, respectively), whereas average GTVs at PET were smaller (20.3 [P ≤ .10] and 16.4 cm3 [P ≤ .01], respectively). GTVs from surgical specimens were significantly smaller (12.6 cm3, P ≤ .06). In nine patients for whom a surgical specimen was available, no modality adequately depicted superficial tumor extension; this was due to limitations in spatial resolution. In addition, false-positive results were seen for cartilage, extralaryngeal, and preepiglottic extensions.

    CONCLUSION: Compared with GTVs at CT and MR imaging, GTVs at FDG PET were smaller. In nine patients for whom a surgical specimen was available, PET was found to be the most accurate modality. However, no modality managed to depict superficial tumor extension.

    © RSNA, 2004

    References

    • 1 Webb S. Three-dimensional radiation-therapy treatment planning In: Webb S. The physics of three-dimensional radiation therapy. Bristol, England: Institute of Physics Publishing, 1993; 1-38. Google Scholar
    • 2 Hermans R, Feron M, Bellon E, Dupont P, Van den Bogaert W, Baert AL. Laryngeal tumor volume measurements determined with CT: a study on intra- and interobserver variability. Int J Radiat Oncol Biol Phys 1998; 40:553-557. Crossref, Medline, Google Scholar
    • 3 Maroldi R, Battaglia G, Farina D, Maculotti P, Chiesa A. Tumours of the oropharynx and oral cavity: perineural spread and bone invasion. JBR-BTR 1999; 82:294-300. Medline, Google Scholar
    • 4 Rasch C, Keus R, Pameijer FA, et al. The potential impact of CT-MRI matching on tumor volume delineation in advanced head and neck cancer. Int J Radiat Oncol Biol Phys 1997; 39:841-848. Crossref, Medline, Google Scholar
    • 5 Delbeke D, Martin WH. Positron emission tomography imaging in oncology. Radiol Clin North Am 2001; 39:883-917. Crossref, Medline, Google Scholar
    • 6 Vanuytsel LJ, Vansteenkiste JF, Stroobants S, et al. The impact of (18)F-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) lymph node staging on the radiation treatment volumes in patients with non-small cell lung cancer. Radiother Oncol 2000; 55:317-324. Crossref, Medline, Google Scholar
    • 7 Bomanji JB, Costa DC, Ell PJ. Clinical role of positron emission tomography in oncology. Lancet Oncol 2001; 2:157-164. Crossref, Medline, Google Scholar
    • 8 Daisne JF, Sibomana M, Bol A, Lonneux M, Doumont T, Grégoire V. Tri-dimensional automatic segmentation of PET volumes based on measured source-to-background ratios: influence of reconstruction algorithms. Radiother Oncol 2003; 69:247-250. Crossref, Medline, Google Scholar
    • 9 Daisne JF, Sibomana M, Bol A, Cosnard G, Lonneux M, Grégoire V. Evaluation of a multimodality image (CT, MRI and PET) coregistration procedure on phantom and head and neck cancer patients: accuracy, reproducibility and consistency. Radiother Oncol 2003; 69:237-245. Crossref, Medline, Google Scholar
    • 10 Becker M, Zbären P, Laeng H, Stoupis C, Porcellini B, Vock P. Neoplastic invasion of laryngeal cartilage: comparison of MR imaging and CT with histopathologic correlation. Radiology 1995; 194:661-669. Link, Google Scholar
    • 11 Wong WL, Hussain K, Chevretton E, et al. Validation and clinical application of computer-combined computed tomography and positron emission tomography with 2-[18F]fluoro-2-deoxy-D-glucose head and neck images. Am J Surg 1996; 172:628-632. Crossref, Medline, Google Scholar
    • 12 Anzai Y, Minoshima S, Wolf GT, Wahl RL. Head and neck cancer: detection of recurrence with three-dimensional principal components analysis at dynamic FDG PET. Radiology 1999; 212:285-290. Link, Google Scholar
    • 13 Doshi NK, Shao Y, Silverman RW, Cherry SR. Design and evaluation of an LSO PET detector for breast cancer imaging. Med Phys 2000; 27:1535-1543. Crossref, Medline, Google Scholar
    • 14 Leahy R, Qi J. Statistical approaches in quantitative positron emission tomography. Stat Comput 2000; 10:147-165. Crossref, Google Scholar
    • 15 Chatziioannou AF, Cherry SR, Shao Y, et al. Performance evaluation of microPET: a high-resolution lutetium oxyorthosilicate PET scanner for animal imaging. J Nucl Med 1999; 40:1164-1175. Medline, Google Scholar
    • 16 Lenz M, Grees H, Baum U, Dobritz M, Kersting-Sommerhoff B. Oropharynx, oral cavity, floor of the mouth: CT and MRI. Eur J Radiol 2000; 33:203-215. Crossref, Medline, Google Scholar
    • 17 Crecco M, Vidiri A, Angelone ML, Palma O, Morello R. Retromolar trigone tumors: evaluation by magnetic resonance imaging and correlation with pathological data. Eur J Radiol 1999; 32:182-188. Crossref, Medline, Google Scholar
    • 18 Jones AS, England J, Hamilton J, et al. Mandibular invasion in patients with oral and oropharyngeal squamous carcinoma. Clin Otolaryngol 1997; 22:239-245. Crossref, Medline, Google Scholar
    • 19 Zbären P, Becker M, Läng H. Pretherapeutic staging of laryngeal carcinoma: clinical findings, computed tomography and magnetic resonance imaging compared with histopathology. Cancer 1996; 77:1263-1273. Crossref, Medline, Google Scholar
    • 20 Kazkayasi M, Önder T, Özkaptan Y, Can C, Pabusçu Y. Comparison of preoperative computed tomographic findings with postoperative histopathological findings in laryngeal carcinoma. Eur Arch Otorhinolaryngol 1995; 252:325-331. Medline, Google Scholar
    • 21 Grandjean E, Debry C, Briche D, el Jerrarri A, Gentine A, Conraux C. Corrélations anatomo-scanographiques des cancers du pharyngo-larynx: a propos d’une étude prospective portant sur 35 patients. Ann Otolaryngol Chir Cervicofac 1993; 110:135-141. Medline, Google Scholar
    • 22 Miller TR, Wallis JW, Grothe RA. Design and use of PET tomographs: the effect of slice spacing. J Nucl Med 1990; 31:1732- 1739. Medline, Google Scholar

    Article History

    Published in print: Oct 2004