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Tommy Knöös

Sjukhusfysiker

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A dose based approach for evaluation of inter-observer variations in target delineation

Författare

  • Ingrid Kristensen
  • Kristina Nilsson
  • Måns Agrup
  • Karin Belfrage
  • Anna Embring
  • Hedda Haugen Cange
  • Anna-Maja Svärd
  • Tommy Knöös
  • Per Nilsson

Summary, in English

Background and purpose: Substantial inter-observer variations in target delineation have been presented previously. Target delineation for paediatric cases is difficult due to the small number of children, the variation in paediatric targets, the number of study protocols, and the individual patient's specific needs and demands. Uncertainties in target delineation might lead to under-dosage or over-dosage. The aim of this work is to apply the concept of a consensus volume and good quality treatment plans to visualise and quantify inter-observer target delineation variations in dosimetric terms in addition to conventional geometrically based volume concordance indices.

Material and methods: Two paediatric cases were used to demonstrate the potential of adding dose metrics when evaluating target delineation diversity; Hodgkin's disease (case 1) and rhabdomyosarcoma of the parotid gland (case 2). The variability in target delineation (PTV delineations) between six centres was quantified using the generalised conformity index, CIgen, generated for volume overlap. The STAPLE algorithm, as implemented in CERR, was used for both cases to derive a consensus volumes. STAPLE is a probabilistic estimate of the true volume generated from all observers. Dose distributions created by each centre for the original target volumes were then applied to this consensus volume.

Results: A considerable variation in target segmentation was seen in both cases. For case 1 the variation was 374-960 cm3 (average 669 cm3) and for case 2; 65-126 cm3 (average 109 cm3). CIgen were 0.53 and 0.70, respectively. The DVHs in absolute volume displayed for the delineated target volume as well as for the consensus volume adds information on both "compliant" target volumes as well as outliers which are hidden with just the use of concordance indices.

Conclusions: The DVHs in absolute volume add valuable and easily understood information to various indices for evaluating uniformity in target delineation.

Avdelning/ar

  • Systemisk strålterapi
  • Radiotherapy Physics
  • Medicinsk strålningsfysik, Lund
  • BioCARE: Biomarkers in Cancer Medicine improving Health Care, Education and Innovation

Publiceringsår

2017-11-04

Språk

Engelska

Sidor

41-47

Publikation/Tidskrift/Serie

Technical Innovations and Patient Support in Radiation Oncology

Volym

3-4

Dokumenttyp

Artikel i tidskrift

Förlag

Elsevier

Ämne

  • Radiology, Nuclear Medicine and Medical Imaging
  • Cancer and Oncology
  • Pediatrics

Status

Published

Forskningsgrupp

  • Radiotherapy Physics

ISBN/ISSN/Övrigt

  • ISSN: 2405-6324