Prospective intra/inter-observer evaluation of pre-brachytherapy cervical cancer tumor width measured in TRUS and MR imaging

Ultrasound (US) imaging has been proved as an excellent diagnostic tool in gynecology and, due to its wide availability and limited cost, is under intense investigation as base for dose adaptation in cervical cancer brachytherapy. Purpose of this work is to test inter/intra-observer uncertainties be...

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Published in:Radiation oncology (London, England) England), 2019-10, Vol.14 (1), p.173-10, Article 173
Main Authors: Federico, Mario, Hernandez-Socorro, Carmen Rosa, Ribeiro, Ivone, Martin, Jesus Gonzalez, Oramas, Maria Dolores Rey-Baltar, Saez-Bravo, Marta Lloret, Jimenez, Pedro Carlos Lara
Format: Article
Language:English
Subjects:
3D brachytherapy
Adenocarcinoma - pathology
Adenocarcinoma - radiotherapy
Adenocarcinoma, Clear Cell - pathology
Adenocarcinoma, Clear Cell - radiotherapy
Adult
Aged
Aged, 80 and over
Brachytherapy
Cancer patients
Carcinoma, Squamous Cell - pathology
Carcinoma, Squamous Cell - radiotherapy
Care and treatment
Cervical Cancer
Female
Health aspects
Humans
Image guided brachytherapy
Magnetic resonance
Magnetic resonance imaging
Magnetic Resonance Imaging - methods
Medical imaging equipment
Middle Aged
Observer Variation
Prognosis
Prospective Studies
Radiotherapy
TRUS
Tumors
Ultrasonography - methods
Ultrasound
Uterine Cervical Neoplasms - pathology
Uterine Cervical Neoplasms - radiotherapy
Young Adult
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Summary:Ultrasound (US) imaging has been proved as an excellent diagnostic tool in gynecology and, due to its wide availability and limited cost, is under intense investigation as base for dose adaptation in cervical cancer brachytherapy. Purpose of this work is to test inter/intra-observer uncertainties between magnetic resonance (MR) and trans-rectal ultrasound (TRUS) imaging in defining maximum tumor width before first brachytherapy (BT) application in a prospective cohort of cervical cancer patients undergoing image-guided adaptive brachytherapy (IGABT). One hundred ten consecutive cervical cancer patients treated between 2013 and 2016 were included. Before the first BT implant patients underwent MR and TRUS scan with no applicator in place. Images were independently analyzed by three examiners, blinded to the other's results. With clinical information at hand, maximum tumor width was measured on preBT TRUS and MR. Quantitative agreement analysis was undertaken. Intra-class correlation coefficient (ICC), Passing-Bablok and Bland Altman plots were used to evaluate the intra/inter-observers measurement agreement. Average difference between tumor width measured on MR (HRCTV ) and TRUS (HRCTV ) was 1.3 ± 3.2 mm (p 
ISSN:1748-717X
1748-717X
DOI:10.1186/s13014-019-1352-7