Department of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho, Kitaku, Okayama, Japan.
Department of Proton Beam Therapy, Okayama University Medical School, 2-5-1 Shikata-cho, Kitaku, Okayama, Japan.
J Radiat Res. 2019 Jul 1;60(4):483-489. doi: 10.1093/jrr/rrz012.
This study aimed to compare the interobserver variabilities in magnetic resonance imaging (MRI)/computed tomography (CT) fusion image-based post-implant dosimetry of permanent prostate brachytherapy (PPB) between 1.5-T and 3.0-T MRI. The study included 60 patients. Of these patients, 30 underwent 1.5-T MRI and CT 30 days after seed implantation (1.5-T group), and 30 underwent 3.0-T MRI and CT 30 days after seed implantation (3.0-T group). All patients received PPB alone. Two radiation oncologists performed MRI/CT fusion image-based post-implant dosimetry, and the interobserver variabilities of dose-volume histogram (DVH) parameters [dose (Gy) received by 90% of the prostate volume (prostate D90)], percentage of the prostate volume receiving at least the full prescribed dose (prostate V100), percentage of the prostate volume receiving at least 150% of the prescribed dose (prostate V150), dose (Gy) received by 5% of the urethral volume (urethral D5) and the urethral volume receiving at least 150% of the prescribed dose (urethral V150)] were retrospectively estimated using the paired Student's t test and Pearson's correlation coefficient. The Pearson's correlation coefficients of all DVH parameters were higher in the 3.0-T group than in the 1.5-T group (1.5-T vs 3.0-T: prostate D90, 0.65 vs 0.93; prostate V100, 0.62 vs 0.82; prostate V150, 0.97 vs 0.98; urethral D5, 0.92 vs 0.93; and urethral V150, 0.88 vs 0.93). In the paired Student's t test, no significant differences were observed in any of the DVH parameters between the two radiation oncologists in the 3.0-T group (0.068 ≤ P ≤ 0.842); however, significant differences were observed in prostate D90 (P = 0.004), prostate V100 (P = 0.011) and prostate V150 (P = 0.002) between the oncologists in the 1.5-T group. The interobserver variability of DVH parameters in the MRI/CT fusion image-based post-implant dosimetry analysis of brachytherapy was lower with 3.0-T MRI than with 1.5-T MRI.
本研究旨在比较 1.5T 和 3.0T MRI 融合图像引导下永久性前列腺近距离治疗(PPB)植入后剂量学的观察者间变异性。该研究纳入了 60 例患者。其中,30 例患者在种子植入后 30 天接受了 1.5T MRI 和 CT(1.5T 组),30 例患者接受了 3.0T MRI 和 CT(3.0T 组)。所有患者均单独接受了 PPB。两位放射肿瘤学家对 MRI/CT 融合图像引导下的植入后剂量学进行了评估,采用配对学生 t 检验和 Pearson 相关系数法对剂量体积直方图(DVH)参数(前列腺 D90 为 90%的前列腺体积接受的剂量(Gy))、前列腺 V100(接受至少全处方剂量的前列腺体积百分比)、前列腺 V150(接受至少 150%处方剂量的前列腺体积百分比)、接受 5%尿道体积的剂量(Gy)(尿道 D5)和接受至少 150%处方剂量的尿道体积(尿道 V150))的观察者间变异性进行了回顾性评估。3.0T 组的所有 DVH 参数的 Pearson 相关系数均高于 1.5T 组(1.5T 与 3.0T:前列腺 D90,0.65 与 0.93;前列腺 V100,0.62 与 0.82;前列腺 V150,0.97 与 0.98;尿道 D5,0.92 与 0.93;尿道 V150,0.88 与 0.93)。在配对学生 t 检验中,3.0T 组中两位放射肿瘤学家在任何 DVH 参数上均未观察到显著差异(0.068≤P≤0.842);然而,在 1.5T 组中,前列腺 D90(P=0.004)、前列腺 V100(P=0.011)和前列腺 V150(P=0.002)的观察者间差异有统计学意义。3.0T MRI 引导下近距离治疗植入后剂量学分析中,DVH 参数的观察者间变异性低于 1.5T MRI。