Inter-observer Variation in Outlining of Pre-trial Test Case in the SCOPE1 Trial: A United Kingdom Definitive Chemoradiotherapy Trial for Esophageal Cancer

Improving radiotherapy quality assurance in clinical trials: assessment of target volume delineation of the pre-accrual benchmark case

“…The OISG would encourage ongoing discussion with chief investigators in order to provide advice on individual aspects of benchmark case assessment for current and future trials. Trial SCOPE 1 GTV [20] SCALOP GTV [41] ARISTOTLE CTVA a, [42] No Values are median unless otherwise specified. DI, discordance index; GMI, geographical miss index; GTV, gross tumour volume; JCI, Jaccard conformity index.…”

“…The Outlining and Imaging Subgroup (OISG) has responsibility for outlining and imaging for target delineation. Although we recognise that there are several sources of error during the TVD stage of multicentre trials, our work to date suggests that the errors of greatest magnitude have been a result of misinterpretation of radiological anatomy [20]. Variations will occur for other reasons, such as different window settings or different planning system algorithms for calculating volumes.…”

“…Work has been conducted on the SCOPE 1 [20,40], SCALOP [41] and ARISTOTLE [42] trials. From this work, the advantages and disadvantages of the different CIs can be determined, and these are detailed in Table 1.…”

“…A method of measuring CIs on a slice-by-slice basis may be more informative. At the time of writing, there are tools available to calculate both JCI/GMI/DI (local conformity) [20] and the MDC on a slice-by-slice basis (axial conformity), and these tools have been applied to the SCOPE 1 [40], SCALOP (SM, unpublished work, Northampton General Hospital, 2011-12) and ARISTOTLE accrual benchmark cases [42].…”

Prospective review of radiotherapy trials through implementation of standardized multicentre workflow and IT infrastructure

“…It was custom built and validated for the purpose of analyzing and sharing RT data for research purposes 12 and our RTTQA group had previous experience of its use. 13 A compiled version (a stand-alone version without the need for licence or specific IT infrastructure) was provided by the Database and IT Solutions subgroup of the UK RTTQA group (http://www.rttrialsqa.org.uk/rttqa/). It can be downloaded at a remote site within minutes and a user guide is also made available.…”