Document Detail


Radiographic and anatomic basis for prostate contouring errors and methods to improve prostate contouring accuracy.
MedLine Citation:
PMID:  19515511     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Use of highly conformal radiation for prostate cancer can lead to both overtreatment of surrounding normal tissues and undertreatment of the prostate itself. In this retrospective study we analyzed the radiographic and anatomic basis of common errors in computed tomography (CT) contouring and suggest methods to correct them. METHODS AND MATERIALS: Three hundred patients with prostate cancer underwent CT and magnetic resonance imaging (MRI). The prostate was delineated independently on the data sets. CT and MRI contours were compared by use of deformable registration. Errors in target delineation were analyzed and methods to avoid such errors detailed. RESULTS: Contouring errors were identified at the prostatic apex, mid gland, and base on CT. At the apex, the genitourinary diaphragm, rectum, and anterior fascia contribute to overestimation. At the mid prostate, the anterior and lateral fasciae contribute to overestimation. At the base, the bladder and anterior fascia contribute to anterior overestimation. Transition zone hypertrophy and bladder neck variability contribute to errors of overestimation and underestimation at the superior base, whereas variable prostate-to-seminal vesicle relationships with prostate hypertrophy contribute to contouring errors at the posterior base. CONCLUSIONS: Most CT contouring errors can be detected by (1) inspection of a lateral view of prostate contours to detect projection from the expected globular form and (2) recognition of anatomic structures (genitourinary diaphragm) on the CT scans that are clearly visible on MRI. This study shows that many CT prostate contouring errors can be improved without direct incorporation of MRI data.
Authors:
Patrick W McLaughlin; Cheryl Evans; Mary Feng; Vrinda Narayana
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2009-06-08
Journal Detail:
Title:  International journal of radiation oncology, biology, physics     Volume:  76     ISSN:  1879-355X     ISO Abbreviation:  Int. J. Radiat. Oncol. Biol. Phys.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-01     Completed Date:  2010-02-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7603616     Medline TA:  Int J Radiat Oncol Biol Phys     Country:  United States    
Other Details:
Languages:  eng     Pagination:  369-78     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Elsevier Inc. All rights reserved.
Affiliation:
Department of Radiation Oncology, University of Michigan, Ann Arbor, MI 48374-1236, USA. mclaughb@umich.edu
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Diagnostic Errors / prevention & control
Humans
Magnetic Resonance Imaging / methods*
Male
Observer Variation
Penis / anatomy & histology,  radiography
Prostate* / anatomy & histology,  pathology,  radiography
Prostatic Hyperplasia / pathology,  radiography
Prostatic Neoplasms / pathology*,  radiography*
Pubic Symphysis / anatomy & histology,  radiography
Rectum / anatomy & histology,  radiography
Retrospective Studies
Seminal Vesicles / pathology,  radiography
Tomography, Spiral Computed / methods*
Urethra / anatomy & histology,  radiography

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Long-term outcome of gamma knife radiosurgery for treatment of typical trigeminal neuralgia.
Next Document:  Clinical Evaluation of Stereotactic Target Localization Using 3-Tesla MRI for Radiosurgery Planning.