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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Defining the target volume for post-operative radiotherapy after D2 dissection in gastric cancer by CT-based vessel-guided delineation
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Defining the target volume for post-operative radiotherapy after D2 dissection in gastric cancer by CT-based vessel-guided delineation

机译：通过基于CT的血管引导划界确定胃癌D2夹层术后放射治疗的目标体积

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Purpose To determine the recurrent nodal gross tumor volume (rnGTV) based on CT-guided vascular structure to refine the clinical target volume (CTV) delineation in postoperative radiotherapy for advanced gastric cancer following radical gastrectomy with D2 dissection. Materials and methods We retrospectively reviewed follow-up images from 91 patients with their first regional recurrence after D2 dissection in stage III gastric cancer with N3 disease. We defined rnGTV as recurrent nodes shown in follow-up CT images, in which one diagnostic radiologist with specialty of gastrointestinal tract investigated. We drew rnGTVs at the equivalent location based on the same vessels of reference comparing CT images to recurrence CT images. Results We propose vessel-based locations of rnGTVs on CT images with axial and coronal views. We show different patterns of regional recurrence according to the location of primary gastric cancer using CT and digitally reconstructed radiograph (DRR) images. Frequently recurred sites, overlapped by more than five rnGTVs, are depicted in a DRR image. Conclusions This study suggests vessel-based delineations of rnGTVs on CT images depending on nodal recurrence sites from follow-up images after D2 lymphadenectomy. Our results could help reduce the inter-observer variation of CTV delineation after D2 dissection in gastric cancer.
机译：目的根据CT引导下的血管结构确定复发性淋巴结总肿瘤体积（rnGTV），以完善D2淋巴结清扫术后晚期胃癌术后放疗的临床目标体积（CTV）轮廓。材料和方法我们回顾性分析了91例D3淋巴结转移性N3胃癌D2切除后首次复发的患者的随访图像。我们将rnGTV定义为后续CT图像中显示的复发性淋巴结，其中一名具有胃肠道专长的放射诊断医生进行了调查。我们根据比较CT图像和复发性CT图像的相同参考血管在相同位置绘制rnGTV。结果我们建议在具有轴向和冠状视图的CT图像上基于rnGTV的血管位置。我们使用CT和数字重建的X射线照片（DRR）根据原发性胃癌的位置显示不同的区域复发模式。在DRR图像中描绘了频繁重复的站点，这些站点与五个以上的rnGTV重叠。结论这项研究表明CT图像上rnGTV的基于血管的划分取决于D2淋巴结清扫术后随访图像中的淋巴结复发部位。我们的结果可能有助于减少胃癌D2解剖后CTV划定的观察者间差异。

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