Inter- and intra-observer variation in soft-tissue sarcoma target definition

Roberge, David; Skamene, T.; Turcotte, Robert; Powell, T.; Saran, Neil; Freeman, Carolyn R.

doi:10.1016/j.canrad.2011.03.006

Cited by 18 publications

(12 citation statements)

References 17 publications

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“…In this project, the GTV contour agreements among 12 sarcoma radiation oncologists for each of 2 RPS cases were “almost perfect” (kappa values of 0.84 and 0.92, respectively). This high level of GTV agreement is consistent with that found in other reports which assessed contour agreement for soft tissue sarcoma of the extremity (24, 25). …”

Section: Discussionsupporting

confidence: 90%

Retroperitoneal Sarcoma Target Volume and Organ at Risk Contour Delineation Agreement Among NRG Sarcoma Radiation Oncologists

Baldini

Abrams

Bosch

et al. 2015

International Journal of Radiation Oncology*Biology*Physics

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Purpose-The purpose of this study was to evaluate the variability in target volume and organ at risk (OAR) contour delineation for retroperitoneal sarcoma (RPS) among 12 sarcoma radiation oncologists.Methods and Materials-Radiation planning computed tomography (CT) scans for 2 cases of RPS were distributed among 12 sarcoma radiation oncologists with instructions for contouring gross tumor volume (GTV), clinical target volume (CTV), high-risk CTV (HR CTV: area judged to be at high risk of resulting in positive margins after resection), and OARs: bowel bag, small bowel, colon, stomach, and duodenum. Analysis of contour agreement was performed using the simultaneous truth and performance level estimation (STAPLE) algorithm and kappa statistics. HHS Public Access Author Manuscript Author ManuscriptAuthor Manuscript Author ManuscriptResults-Ten radiation oncologists contoured both RPS cases, 1 contoured only RPS1, and 1 contoured only RPS2 such that each case was contoured by 11 radiation oncologists. The first case (RPS 1) was a patient with a de-differentiated (DD) liposarcoma (LPS) with a predominant welldifferentiated (WD) component, and the second case (RPS 2) was a patient with DD LPS made up almost entirely of a DD component. Contouring agreement for GTV and CTV contours was high. However, the agreement for HR CTVs was only moderate. For OARs, agreement for stomach, bowel bag, small bowel, and colon was high, but agreement for duodenum (distorted by tumor in one of these cases) was fair to moderate.Conclusions-For preoperative treatment of RPS, sarcoma radiation oncologists contoured GTV, CTV, and most OARs with a high level of agreement. HR CTV contours were more variable. Further clarification of this volume with the help of sarcoma surgical oncologists is necessary to reach consensus. More attention to delineation of the duodenum is also needed.

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Section: Discussionsupporting

confidence: 90%

Retroperitoneal Sarcoma Target Volume and Organ at Risk Contour Delineation Agreement Among NRG Sarcoma Radiation Oncologists

Baldini

Abrams

Bosch

et al. 2015

International Journal of Radiation Oncology*Biology*Physics

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“…These factors need to be thoroughly taught and assessed by any radiation oncology training programme. It is important to note that consistency of contouring does not necessarily improve with experience, seniority, volume of patients seen or observer confidence …”

Section: Discussionmentioning

confidence: 99%

“…19,75 These factors need to be thoroughly taught and assessed by any radiation oncology training programme. It is important to note that consistency of contouring does not necessarily improve with experience, 76,77 seniority, 78 volume of patients seen 79 or observer confidence. 80 Variability in volume delineation needs to be addressed along with the other quality assurance checks in radiotherapy.…”

Section: Discussionmentioning

confidence: 99%

A review of interventions to reduce inter‐observer variability in volume delineation in radiation oncology

et al. 2016

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“…Volume changes between planning CT scan and the reference CBCT scan and changes during RT could also be the result of delineation uncertainties. Delineation on MR scan could be more accurate, but even in this modality significant inter- and intra-observer variation have been demonstrated [21]. Furthermore, we assumed that changes in the CTV behaved similar to changes in the GTV.…”

Section: Discussionmentioning

confidence: 99%

Volume changes in soft tissue sarcomas during preoperative radiotherapy of extremities evaluated using cone-beam CT

2013

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ObjectiveThe objective of this study is to quantify volume changes in the gross target volume (GTV) during preoperative radiotherapy for extremity soft tissue sarcomas (ESTS).MethodsTwenty-seven patients with ESTS, treated with preoperative radiotherapy, were included in this study. Weekly cone-beam CT scans acquired for setup correction were used for GTV delineation in order to quantify volume changes over the course of treatment. Age, anatomical location, tumour type and tumour volume were evaluated as predictive factors for volume changes. Finally, the optimal time point for adaptive intervention was quantified.ResultsA GTV increase to a maximum of 28 % occurred in five patients. Thirteen patients showed no change and nine patients (all diagnosed with myxoid liposarcoma (MLS)) showed a GTV decrease to a maximum of 57 % of the GTV volume at start of treatment. In the multivariate analysis, only the relative volume change for tumour type was significant (p = 0.001). The optimal time point for adaptive intervention in non-MLS patients was the first week and for MLS patients the third week.ConclusionsVolume changes were quantified during preoperative RT of ESTS. Volume decrease was observed only in MLS patients. Individualised treatment resulting in plan adaptations could result in a clinically useful volume reduction for MLS patients.

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Inter- and intra-observer variation in soft-tissue sarcoma target definition

Cited by 18 publications

References 17 publications

Retroperitoneal Sarcoma Target Volume and Organ at Risk Contour Delineation Agreement Among NRG Sarcoma Radiation Oncologists

Retroperitoneal Sarcoma Target Volume and Organ at Risk Contour Delineation Agreement Among NRG Sarcoma Radiation Oncologists

A review of interventions to reduce inter‐observer variability in volume delineation in radiation oncology

Volume changes in soft tissue sarcomas during preoperative radiotherapy of extremities evaluated using cone-beam CT

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