Yoshida EJ, Chen H, Torres M, Andic F, Liu HY, Chen Z, Sun X, Curran WJ, Liu T, et al.
International journal of radiation oncology, biology, physics. Date of publication 2012 Feb 1;volume 82(2):724-31.
1. Int J Radiat Oncol Biol Phys. 2012 Feb 1;82(2):724-31. doi:
10.1016/j.ijrobp.2010.12.066. Epub 2011 Mar 23.
Reliability of quantitative ultrasonic assessment of normal-tissue toxicity in
breast cancer radiotherapy.
Yoshida EJ(1), Chen H, Torres M, Andic F, Liu HY, Chen Z, Sun X, Curran WJ, Liu
T.
Author information:
(1)Department of Radiation Oncology, Emory University, Atlanta, GA 30322, USA.
PURPOSE: We have recently reported that ultrasound imaging, together with
ultrasound tissue characterization (UTC), can provide quantitative assessment of
radiation-induced normal-tissue toxicity. This study's purpose is to evaluate the
reliability of our quantitative ultrasound technology in assessing acute and late
normal-tissue toxicity in breast cancer radiotherapy.
METHOD AND MATERIALS: Our ultrasound technique analyzes radiofrequency echo
signals and provides quantitative measures of dermal, hypodermal, and glandular
tissue toxicities. To facilitate easy clinical implementation, we further refined
this technique by developing a semiautomatic ultrasound-based toxicity assessment
tool (UBTAT). Seventy-two ultrasound studies of 26 patients (720 images) were
analyzed. Images of 8 patients were evaluated for acute toxicity (<6 months
postradiotherapy) and those of 18 patients were evaluated for late toxicity (≥ 6
months postradiotherapy). All patients were treated according to a standard
radiotherapy protocol. To assess intraobserver reliability, one observer analyzed
720 images in UBTAT and then repeated the analysis 3 months later. To assess
interobserver reliability, three observers (two radiation oncologists and one
ultrasound expert) each analyzed 720 images in UBTAT. An intraclass correlation
coefficient (ICC) was used to evaluate intra- and interobserver reliability.
Ultrasound assessment and clinical evaluation were also compared.
RESULTS: Intraobserver ICC was 0.89 for dermal toxicity, 0.74 for hypodermal
toxicity, and 0.96 for glandular tissue toxicity. Interobserver ICC was 0.78 for
dermal toxicity, 0.74 for hypodermal toxicity, and 0.94 for glandular tissue
toxicity. Statistical analysis found significant changes in dermal (p < 0.0001),
hypodermal (p = 0.0027), and glandular tissue (p < 0.0001) assessments in the
acute toxicity group. Ultrasound measurements correlated with clinical Radiation
Therapy Oncology Group (RTOG) toxicity scores of patients in the late toxicity
group. Patients with RTOG Grade 1 or 2 had greater ultrasound-assessed toxicity
percentage changes than patients with RTOG Grade 0.
CONCLUSION: Early and late radiation-induced effects on normal tissue can be
reliably assessed using quantitative ultrasound.
Copyright © 2012 Elsevier Inc. All rights reserved.
DOI: 10.1016/j.ijrobp.2010.12.066
PMCID: PMC3156354
PMID: 21435799 [Indexed for MEDLINE]
