| ORIGINAL ARTICLE |
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| Year : 2008 | Volume
: 4
| Issue : 1 | Page : 9-13 |
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Implications of contrast-enhanced CT-based and MRI-based target volume delineations in radiotherapy treatment planning for brain tumors
Niloy R Datta1, Rajasekar David2, Rakesh K Gupta3, Punita Lal2
1 Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
2 Department of Radiotherapy, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
3 Department of Radiodiagnosis and Imaging, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
Correspondence Address:
Niloy R Datta
Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, Sector-5, Rohini, New Delhi - 110 085
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0973-1482.39598
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Delineation of various target volumes using contrast-enhanced magnetic resonance imaging (MRI) and/or computed tomography (CT) constitutes the primary step for radiation therapy planning (RTP) in brain tumors. This study presents a quantification and comparative evaluation of the various clinical target volumes (CTV) and gross target volumes (GTV) as outlined by contrast-enhanced CT and MRI, along with its implications for postoperative radiotherapy of brain tumors.
Twenty-one patients of gliomas were considered for this prospective study. Peritumoral edema as CTV and residual tumor as GTV were delineated separately in postoperative contrast-enhanced CT and MRI. These volumes were estimated separately and their congruence studied for contrast-enhanced CT and MRI. Compared to MRI, CT underestimated the volumes, with significant differences seen in the mean CTV (mean ± SD: −62.92 ± 93.99 cc; P = 0.006) and GTV (mean ± SD: −21.08 ± 36.04 cc; P = 0.014). These differences were found to be significant for high-grade gliomas (CTV: P = 0.045; GTV: P = 0.044), while they were statistically insignificant for low-grade gliomas (CTV: P = 0.080; GTV: P = 0.117). The mean differences in the volumes for CTV and GTV were estimated to be −106.7% and −62.6%, respectively, taking the CT volumes as the baseline.
Thus, even though, electron density information from CT is essential for RTP, target delineation during postoperative radiotherapy of brain tumors, especially for high-grade tumors, should be based on MRI so as to avoid inadvertent geographical misses, especially in the regions of peritumoral edema. |
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