Volume Delineation in Cervical Cancer With T2 and Diffusion-weighted MRI: Agreement on Volumes Between Observers.
AIM
To delineate cervical cancer gross tumor volume (GTV) on T2-magnetic resonance imaging (MRI) and apparent diffusion coefficient (ADC) maps, assessing volumes and inter-observer agreement between two observers.


PATIENTS AND METHODS
A radiologist and a radiation oncologist delineated GTV on T2 (T2GTV) and ADC (ADCGTV) sequences. Dice similarity index (DICE) and Bland-Altman analysis were used to estimated concordance.


RESULTS
Mean T2GTV and ADCGTV volumes were 43.84±71.47 cc and 37.28±68.92 cc according to the radiologist, and 43.4±70.44 cc and 36.65±69.21 cc according to the radiation oncologist. ADC led to statistically significantly smaller volumes compared to T2. The mean DICE index was 0.86 for T2GTV and 0.84 for ADCGTV The Bland-Altman plots globally showed concordance.


CONCLUSION
GTV delineation was smaller in the ADC maps compared to T2-MRI, reaching an almost perfect agreement between observers. Thanks to this acceptable variability, adding functional imaging might provide more information for tumor delineation, improving reproducibility for image-guided adaptive radiotherapy.
['Rosa|Consuelo|C|', 'Pizzi|Andrea Delli|AD|', 'Augurio|Antonietta|A|', 'Caravatta|Luciana|L|', 'DI Tommaso|Monica|M|', 'Mincuzzi|Erica|E|', 'Cinalli|Sebastiano|S|', 'Basilico|Raffaella|R|', 'Porreca|Annamaria|A|', 'DI Nicola|Marta|M|', 'Genovesi|Domenico|D|']
D005260:Female D006801:Humans D008279:Magnetic Resonance Imaging D015588:Observer Variation D015203:Reproducibility of Results D047368:Tumor Burden D002583:Uterine Cervical Neoplasms
Cervical cancer inter-observer agreement radiotherapy magnetic resonance imaging