Article Figures & Data
Figures
- FIG 1.
Examples of volume amendments made at peer review. Selected images show the difference in GTVonc and GTVrad delineations. A and B, T2-weighted axial images show an intermediate-signal left piriform fossa tumor (arrows). Following review of the diffusion-weighted imaging (b = 1000) (single arrow) (C), the contouring on T1-weighted gadolinium-enhanced axial image is expanded from GTVonc (red) to GTVrad (green) (D). T2-weighted axial image demonstrates multiple bilateral lymph nodes. The left submandibular gland (arrow) was initially included in the GTVonc (red) because it was isointense to other pathologic lymph nodes. F, Diffusion-weighted imaging (b = 1000) aided in the identification of the lower signal submandibular gland; hence, it was excluded from GTVrad (green).
- FIG 2.
Factors contributing to volume amendments: GTVT and GTVN. 1Changes made following joint discussion between the oncologist and radiologist, eg, inclusion of lymph nodes with borderline pathologic changes. 2Diffusion-weighted MR imaging sequences. 3Tumor volumes described as complex by the oncologist and radiologist at the time of peer review. Includes skull base disease with perineural spread, septate tumor, and postexcisional biopsy changes.
- FIG 3.
Boxplots of percentage volume change for GTVT by subsite. Case number 22 and 24 (highlighted as superscript numbers on the box plot of oropharyngeal cancer cases) are outliers in terms of percentage volume change. Case 22: the GTVT was reduced by 24.5% on radiologist review due to the removal of normal oral tongue and normal parapharyngeal fat. Case 24; GTVT increased by 41.4% on radiologist review due to imaging misinterpretation of abnormal deep mucosal disease extent.
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