Interobserver variability of clinical target volume delineation of glandular breast tissue and of boost volume in tangential breast irradiation

Struikmans, H.; Wárlám-Rodenhuis, Carla C.; Stam, T.; Stapper, Gerard; Tersteeg, Robbert J.H.A.; Bol, Gijsbert H.; Raaijmakers, Cornelis P.J.

doi:10.1016/j.radonc.2005.03.029

Cited by 154 publications

(95 citation statements)

References 19 publications

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“…That said, CLI were low even for TB 6M in comparison to those previously reported (6,8,23). Table 4 demonstrates that there were significant differences in median TB volumes between observers.…”

Section: Discussionmentioning

confidence: 57%

“…However, where more conformal field arrangements are used, an additional for cavities with CVS=2 versus 87% for cavities with CVS=5. It has been hypothesised that TB markers might reduce IOV although Struikmans et al (8), who reported IOV between five observers outlining 17 cases, found no difference in conformity indices for patients with clips (n=8, CoI=0.56) and without clips (n=9, CoI=0.55). CVS was not measured in this study.…”

Section: Discussionmentioning

confidence: 98%

“…An essential prerequisite of external beam partial breast irradiation (PBI) is accurate localization of the TB, for which many oncologists are using CT imaging. However, CT imaging alone has been found to be associated with significant interobserver variability (IOV) (6)(7)(8) particularly in patients with low-volume seroma (6). Full-thickness apposition of tumour cavity walls following wide local excision is an increasingly common surgical practice based on evidence that it reduces the risk of post-operative infection (9), increases the sensitivity of mammography to detect local recurrence (9), and reduces exposure of cavity walls to potentially tumorigenic wound fluids (10).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Tumour bed delineation for partial breast/breast boost radiotherapy: What is the optimal number of implanted markers?

Kirby

Jena

Harris

et al. 2013

Radiotherapy and Oncology

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Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Tumour bed delineation for partial breast/breast boost radiotherapy: What is the optimal number of implanted markers?

Kirby

Jena

Harris

et al. 2013

Radiotherapy and Oncology

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“…Previously reported values in breast radiotherapy CTV inter-observer studies include a JI of; 0.81 for radiation oncologist breast contouring [9], 0.84 for radiation therapist breast contouring [9], 0.87 for glandular breast volumes [12], 0.56 for partial breast volumes [12] and 0.82 for glioblastoma GTV's (Gross Tumour Volumes) [28]. An inter-observer breast contour generalized kappa of 0.97 (p<0.05), maximal HD of 3.42 mm, average JI of 0.98±0.01 and average DICE of 0.99±0.01 was found in this study.…”

Section: Discussionmentioning

confidence: 99%

“…As such there has been an increasing trend to assess, and reduce, the variability of these target volumes. This study determined the highest concordance metrics achievable, and how these metrics (details given in Supplementary Table 1) including; Jaccard Index (JI also known as conformity index or concordance index (CI) [6,12]), CI pairs the average of all possible pairs of the JI (equates to CI gen when mutual variability between all observers is the same [13]), Dice Coefficient (DICE or DSC), Volume Overlap Index (VOI), the generalised kappa statistic and Hausdorff Distance (HD), may vary in a best case phantom scenario considering: multiple sites, variation between TPSs, shapes, volume, tools utilized and adherence to auto-threshold settings within the protocol.…”

Section: Introductionmentioning

confidence: 99%

A phantom assessment of achievable contouring concordance across multiple treatment planning systems

Pogson

Begg

Jameson

et al. 2015

Radiotherapy and Oncology

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In this paper, the highest level of inter-and intra-observer conformity achievable with different treatment planning systems (TPSs), contouring tools, shapes, and sites have been established for metrics including the Dice similarity coefficient (DICE) 2 AbstractIn this paper, metrics including the Dice similarity coefficient (DICE) and Hausdorff Distance determine the highest level of inter-and intra-observer conformity achievable with different treatment planning systems (TPSs), contouring tools, shapes, and sites. High conformity values, e.g. DICE Breast_Shape =0.99±0.01, are achieved with differing TPSs. Decreasing image resolution decreased contouring conformity.

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Imaging dose in breast radiotherapy: does breast size affect the dose to the organs at risk and the risk of secondary cancer to the contralateral breast?

Batumalai

Quinn

Jameson

et al. 2015

J of Medical Radiation Sci

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IntroductionCorrect target positioning is crucial for accurate dose delivery in breast radiotherapy resulting in utilisation of daily imaging. However, the radiation dose from daily imaging is associated with increased probability of secondary induced cancer. The aim of this study was to quantify doses associated with three imaging modalities and investigate the correlation of dose and varying breast size in breast radiotherapy.MethodsPlanning computed tomography (CT) data sets of 30 breast cancer patients were utilised to simulate the dose received by various organs from a megavoltage computed tomography (MV-CT), megavoltage electronic portal image (MV-EPI) and megavoltage cone-beam computed tomography (MV-CBCT). The mean dose to organs adjacent to the target volume (contralateral breast, lungs, spinal cord and heart) were analysed. Pearson correlation analysis was performed to determine the relationship between imaging dose and primary breast volume and the lifetime attributable risk (LAR) of induced secondary cancer was calculated for the contralateral breast.ResultsThe highest contralateral breast mean dose was from the MV-CBCT (1.79 Gy), followed by MV-EPI (0.22 Gy) and MV-CT (0.11 Gy). A similar trend was found for all organs at risk (OAR) analysed. The primary breast volume inversely correlated with the contralateral breast dose for all three imaging modalities. As the primary breast volume increases, the likelihood of a patient developing a radiation-induced secondary cancer to the contralateral breast decreases. MV-CBCT showed a stronger relationship between breast size and LAR of developing a radiation-induced contralateral breast cancer in comparison with the MV-CT and MV-EPI.ConclusionsFor breast patients, imaging dose to OAR depends on imaging modality and treated breast size. When considering the use of imaging during breast radiotherapy, the patient's breast size and contralateral breast dose should be taken into account.

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Interobserver variability of clinical target volume delineation of glandular breast tissue and of boost volume in tangential breast irradiation

Cited by 154 publications

References 19 publications

Tumour bed delineation for partial breast/breast boost radiotherapy: What is the optimal number of implanted markers?

Tumour bed delineation for partial breast/breast boost radiotherapy: What is the optimal number of implanted markers?

A phantom assessment of achievable contouring concordance across multiple treatment planning systems

Imaging dose in breast radiotherapy: does breast size affect the dose to the organs at risk and the risk of secondary cancer to the contralateral breast?

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