Contouring of the Pharyngeal Superior Constrictor Muscle (PSCM). A cooperative study of the Italian Association of Radiation Oncology (AIRO) Head and Neck Group

Radiother Oncol. 2014 Sep;112(3):337-42. doi: 10.1016/j.radonc.2014.05.016. Epub 2014 Jul 5.

Abstract

Background and purpose: Irradiation of the Pharyngeal Superior Constrictor Muscle (PSCM) seems to play a crucial role in radiation-related swallowing dysfunctions. Purpose of our study was to quantify operator-related variability in the contouring of PSCM on Computed Tomography (CT) scans and adherence with contours derived from MR images.

Materials and methods: Three sets of treatment planning CT and their corresponding MR images were selected. Contouring of the PSCM was performed using both a literature-based method, derived from literature review, and an optimized method, derived from Magnetic Resonance (MR) images thus obtaining "literature-based" and "optimized" contours. Each operator contoured the PSCM on CT scans according to both methods for three times in three different days. Inter- and intra-operator variability and adherence to a contour obtained from MR images (named "MR-derived" contour) were analyzed.

Results: Thirty-four operators participated and 612 contours were obtained. Both intra- and inter-operator variability and adherence to the "MR-derived" contour were significantly different between the two methods (p⩽0.05). The "optimized" method showed a lower intra- and inter-operator variability and a higher adherence to the "MR-derived" contour.

Conclusions: The "optimized" method ameliorates both operator-related variability and adherence with MR images.

Keywords: Dysphagia; Head and neck cancer; IMRT; Pharyngeal constrictor muscles; Toxicity.

Publication types

  • Multicenter Study

MeSH terms

  • Analysis of Variance
  • Humans
  • Italy
  • Magnetic Resonance Imaging / methods*
  • Observer Variation
  • Pharyngeal Muscles / anatomy & histology*
  • Practice Guidelines as Topic
  • Prospective Studies
  • Radiation Oncology / methods*
  • Reproducibility of Results
  • Societies, Medical
  • Tomography, X-Ray Computed / methods*