{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T22:05:04Z","timestamp":1764194704869},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,9,6]],"date-time":"2022-09-06T00:00:00Z","timestamp":1662422400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,9,6]],"date-time":"2022-09-06T00:00:00Z","timestamp":1662422400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Imaging"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Patients with tonsillar cancer (TC) often have dental fillings that can significantly degrade the quality of computed tomography (CT) simulator images due to metal artifacts. We evaluated whether the use of the metal artifact reduction (MAR) algorithm reduced the interobserver variation in delineating gross tumor volume (GTV) of TC.\n<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Eighteen patients with TC with dental fillings were enrolled in this study. Contrast-enhanced CT simulator images were reconstructed using the conventional (CT<jats:sub>CONV<\/jats:sub>) and MAR algorithm (CT<jats:sub>MAR<\/jats:sub>). Four board-certified radiation oncologists delineated the GTV of primary tumors using routine clinical data first on CT<jats:sub>CONV<\/jats:sub> image datasets (GTV<jats:sub>CONV<\/jats:sub>), followed by CT<jats:sub>CONV<\/jats:sub> and CT<jats:sub>MAR<\/jats:sub> fused image datasets (GTV<jats:sub>MAR<\/jats:sub>) at least 2\u00a0weeks apart. Intermodality differences in GTV values and Dice similarity coefficient (DSC) were compared using Wilcoxon\u2019s signed-rank test.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>GTV<jats:sub>MAR<\/jats:sub> was significantly smaller than GTV<jats:sub>CONV<\/jats:sub> for three observers. The other observer showed no significant difference between GTV<jats:sub>CONV<\/jats:sub> and GTV<jats:sub>MAR<\/jats:sub> values. For all four observers, the mean GTV<jats:sub>CONV<\/jats:sub> and GTV<jats:sub>MAR<\/jats:sub> values were 14.0 (standard deviation [SD]: 7.4) cm<jats:sup>3<\/jats:sup> and 12.1 (SD: 6.4) cm<jats:sup>3<\/jats:sup>, respectively, with the latter significantly lower than the former (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). The mean DSC of GTV<jats:sub>CONV<\/jats:sub> and GTV<jats:sub>MAR<\/jats:sub> was 0.74 (SD: 0.10) and 0.77 (SD: 0.10), respectively, with the latter significantly higher than that of the former (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The use of the MAR algorithm led to the delineation of smaller GTVs and reduced interobserver variations in delineating GTV of the primary tumors in patients with TC.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12880-022-00889-0","type":"journal-article","created":{"date-parts":[[2022,9,6]],"date-time":"2022-09-06T14:03:44Z","timestamp":1662473024000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Impact of metal artifact reduction algorithm on gross tumor volume delineation in tonsillar cancer: reducing the interobserver variation"],"prefix":"10.1186","volume":"22","author":[{"given":"Yoshiyuki","family":"Fukugawa","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryo","family":"Toya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomohiko","family":"Matsuyama","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takahiro","family":"Watakabe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshinobu","family":"Shimohigashi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yudai","family":"Kai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tadashi","family":"Matsumoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natsuo","family":"Oya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,9,6]]},"reference":[{"key":"889_CR1","unstructured":"National Comprehensive Cancer Network: NCCN Clinical Practice Guidelines in Oncology, Head and Neck Cancers (Version 2. 2022)."},{"issue":"1","key":"889_CR2","doi-asserted-by":"publisher","first-page":"436","DOI":"10.1080\/07853890.2022.2031270","volume":"54","author":"R Toya","year":"2022","unstructured":"Toya R, Saito T, Fukugawa Y, Matsuyama T, Matsumoto T, Shiraishi S, et al. Prevalence and risk factors of retro-styloid lymph node metastasis in oropharyngeal carcinoma. Ann Med. 2022;54(1):436\u201341.","journal-title":"Ann Med"},{"issue":"1","key":"889_CR3","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1016\/j.prro.2011.06.004","volume":"2","author":"JA Abelson","year":"2012","unstructured":"Abelson JA, Murphy JD, Wiegner EA, Abelson D, Sandman DN, Boas FE, et al. Evaluation of a metal artifact reduction technique in tonsillar cancer delineation. Pract Radiat Oncol. 2012;2(1):27\u201334.","journal-title":"Pract Radiat Oncol"},{"issue":"10","key":"889_CR4","doi-asserted-by":"publisher","first-page":"650","DOI":"10.1007\/s11604-015-0471-9","volume":"33","author":"K Hirata","year":"2015","unstructured":"Hirata K, Utsunomiya D, Oda S, Kidoh M, Funama Y, Yuki H, et al. Added value of a single-energy projection-based metal-artifact reduction algorithm for the computed tomography evaluation of oral cavity cancers. 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Semin Radiat Oncol. 2005;15(3):136\u201345.","journal-title":"Semin Radiat Oncol"}],"container-title":["BMC Medical Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12880-022-00889-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12880-022-00889-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12880-022-00889-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,5]],"date-time":"2022-10-05T12:35:59Z","timestamp":1664973359000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcmedimaging.biomedcentral.com\/articles\/10.1186\/s12880-022-00889-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,6]]},"references-count":17,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["889"],"URL":"https:\/\/doi.org\/10.1186\/s12880-022-00889-0","relation":{},"ISSN":["1471-2342"],"issn-type":[{"value":"1471-2342","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,6]]},"assertion":[{"value":"8 July 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 August 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 September 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study received full approval from the institutional research ethics board of Kumamoto University Hospital (No. 2281) and it conformed to the principles of the Helsinki Declaration. The requirement of individual participant consent was waived by the research ethics board of Kumamoto University Hospital.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"161"}}