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Journal article
VARIABILITY IN CLINICAL TARGET VOLUME DELINEATION FOR INTENSITY MODULATED RADIOTHERAPY IN THREE CHALLENGING CERVIX CANCER SCENARIOS
Practical Radiation Oncology, v 5(6), pp e557-e565
01 Jan 2015
PMID: 26432679
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
<p>Purpose: The purpose of this study was to assess variability in contouring the gross tumor volume (GTV) and clinical target volume (CTV) of 3 clinical cervix cancer cases by a cohort of international experts in the field in preparation for the development of an online teaching atlas.</p><p>Methods and materials: Twelve international experts participated. Three clinical scenarios: node positivity (PLN), retroverted uterus (RV), and parametrial invasion (PI) were used. Sagittal and axial magnetic resonance images of the clinical cases were downloaded to participants' treatment planning systems for contouring. The GTV/cervix/uterus/parametria/vagina and nodal CTV were contoured. Contour consensus was assessed for sensitivity/specificity using an expectation maximization algorithm called Simultaneous Truth and Performance Level Estimation and experts' overall agreement was summarized by kappa statistics.</p><p>Results: Agreement for GTV in the 3 clinical cases was high (Simultaneous Truth and Performance Level Estimation sensitivity, 0.54-0.92; specificity, 0.97-0.98; and kappa measure for PLN, RV, and PI was 0.86, 0.76, and 0.42; P < .0001). Moderate to substantial agreement was seen for nodal CTV (kappa statistics for PLN, RV, and PI was 0.65, 0.58, and 0.62; P < .0001), uterus (kappa for PLN, RV, and PI was 0.45, 0.74, and 0.77; P < .0001), and parametria (kappa for PLN, RV, and PI was 0.49, 0.62, and 0.50; P < .0001). Contouring heterogeneity was greatest for the cervix (kappa measure for PLN, RV, and PI was 0.15, 0.4, and 0.24; P < .0001) and vagina (kappa for PLN, RV, and PI was 0.47, 0.36 and 0.46; P < .0001), reflecting difficulties in determining the interface between GTV and these tissues.</p><p>Conclusion: Kappa statistics of the different CTV components generally demonstrated moderate to substantial agreement among international experts in the field of gynecological radiation therapy. Further planning target volume margins accounting for organ motion and setup errors are a necessary addition to the CTV. (C) 2015 Published by Elsevier Inc. on behalf of American Society for Radiation Oncology.</p>
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Details
- Title
- VARIABILITY IN CLINICAL TARGET VOLUME DELINEATION FOR INTENSITY MODULATED RADIOTHERAPY IN THREE CHALLENGING CERVIX CANCER SCENARIOS
- Creators
- Karen Lim - Liverpool HospitalBeth Erickson - Medical College of WisconsinIna M. Jürgenliemk-SchulzDavid Gaffney - Huntsman Cancer InstituteCarien L. Creutzberg - Leiden University Medical CenterAkila Viswanathan - Harvard UniversityLorraine Portelance - University of MiamiSushil Beriwal - Magee-Womens HospitalAaron Wolfson - University of MiamiWalter Bosch - Washington University in St. LouisJennifer De Los Santos - University of Alabama at BirminghamCatheryn Yashar - University of California, San DiegoAnuja Jhingran - Brigham and Women's HospitalMahesh Varia - University of North Carolina at Chapel HillIssam El NaqaBronwyn King - Epworth HospitalAnthony Fyles - Princess Margaret Cancer Centre
- Publication Details
- Practical Radiation Oncology, v 5(6), pp e557-e565
- Publisher
- ELSEVIER SCIENCE INC; NEW YORK
- Number of pages
- 9
- Grant note
- ATC: U24 CA81647
This project was supported by ATC (National Institutes of Health grant U24 CA81647).
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Radiation Oncology (and Nuclear Medicine)
- Web of Science ID
- WOS:000422362200001
- Scopus ID
- 2-s2.0-84946408007
- Other Identifier
- 991021897283704721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Oncology
- Radiology, Nuclear Medicine & Medical Imaging