Target Volume Delineation Training for Clinical Oncology Trainees: The Role of ARENA and COPP

Evans, Elin; Radhakrishna, Ganesh; Gilson, D.; Hoskin, Peter; Miles, Elizabeth; Yuille, F.; Dickson, Jeanette; Gwynne, S.

doi:10.1016/j.clon.2019.03.003

Cited by 5 publications

(3 citation statements)

References 3 publications

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“…18,21 The RCR ARENA and Clinical Oncology Planning Project (COPP) are some example of initiatives to increase access to expert/peer-led structured outlining training to promote consistency in target volume and OAR outlining, and facilitate robust assessment of outlining practice for all grades of Clinical Oncologists. 43 This study has a number of additional limitations. The workshop was limited in its time/level of interactivity because of restrictions imposed during the pandemic, and this could have impacted on the educational experience/DSC and LDE results that we observed (although participant feedback for the workshop remained positive).…”

Section: Discussionmentioning

confidence: 96%

Evaluation of the impact of teaching on delineation variation during a virtual stereotactic ablative radiotherapy contouring workshop

et al. 2021

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Introduction: Variation in delineation of target volumes/organs at risk (OARs) is well recognised in radiotherapy and may be reduced by several methods including teaching. We evaluated the impact of teaching on contouring variation for thoracic/pelvic stereotactic ablative radiotherapy (SABR) during a virtual contouring workshop. Materials and methods: Target volume/OAR contours produced by workshop participants for three cases were evaluated against reference contours using DICE similarity coefficient (DSC) and line domain error (LDE) metrics. Pre- and post-workshop DSC results were compared using Wilcoxon signed ranks test to determine the impact of teaching during the workshop. Results: Of 50 workshop participants, paired pre- and post-workshop contours were available for 21 (42%), 20 (40%) and 22 (44%) participants for primary lung cancer, pelvic bone metastasis and pelvic node metastasis cases, respectively. Statistically significant improvements post-workshop in median DSC and LDE results were observed for 6 (50%) and 7 (58%) of 12 structures, respectively, although the magnitude of DSC/LDE improvement was modest in most cases. An increase in median DSC post-workshop ≥0·05 was only observed for GTVbone, IGTVlung and SacralPlex, and reduction in median LDE > 1 mm was only observed for GTVbone, CTVbone and SacralPlex. Post-workshop, median DSC values were >0·7 for 75% of structures. For 92% of the structures, post-workshop contours were considered to be acceptable or within acceptable variation following review by the workshop faculty. Conclusions: This study has demonstrated that virtual SABR contouring training is feasible and was associated with some improvements in contouring variation for multiple target volumes/OARs.

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Section: Discussionmentioning

confidence: 96%

Evaluation of the impact of teaching on delineation variation during a virtual stereotactic ablative radiotherapy contouring workshop

et al. 2021

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“…Questionnaire items across five domains were developed using the clinical oncology curriculum [29], the Oncology Registrar's Forum (ORF) 2017 training survey [11] and the annual General Medical Council Training Survey [30]. The iterative process was guided by feedback from the ORF, a clinical oncology medical education research fellow [31] and representative local colleagues across the staffing spectrum.…”

Section: 'Dose Escalation' For Radiotherapy Learningmentioning

confidence: 99%

Local Control: Also a Strength of Radiotherapy Training?

et al. 2021

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“…The definition of its outline is rather based on recurrence studies and thus, empirically built clinical experience [ 30 , 31 ]. This makes the delineation of CTVs a difficult task for clinicians that need many years of training [ 32 ]. Its complexity is not only visible in the training needed to perform this task, but also in the time needed to produce acceptable delineations and in their resulting divergence.…”

Section: Introductionmentioning

confidence: 99%

Segmentation of 71 Anatomical Structures Necessary for the Evaluation of Guideline-Conforming Clinical Target Volumes in Head and Neck Cancers

Walter,

Hoegen-Saßmannshausen,

Stanic

et al. 2024

Cancers

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The delineation of the clinical target volumes (CTVs) for radiation therapy is time-consuming, requires intensive training and shows high inter-observer variability. Supervised deep-learning methods depend heavily on consistent training data; thus, State-of-the-Art research focuses on making CTV labels more homogeneous and strictly bounding them to current standards. International consensus expert guidelines standardize CTV delineation by conditioning the extension of the clinical target volume on the surrounding anatomical structures. Training strategies that directly follow the construction rules given in the expert guidelines or the possibility of quantifying the conformance of manually drawn contours to the guidelines are still missing. Seventy-one anatomical structures that are relevant to CTV delineation in head- and neck-cancer patients, according to the expert guidelines, were segmented on 104 computed tomography scans, to assess the possibility of automating their segmentation by State-of-the-Art deep learning methods. All 71 anatomical structures were subdivided into three subsets of non-overlapping structures, and a 3D nnU-Net model with five-fold cross-validation was trained for each subset, to automatically segment the structures on planning computed tomography scans. We report the DICE, Hausdorff distance and surface DICE for 71 + 5 anatomical structures, for most of which no previous segmentation accuracies have been reported. For those structures for which prediction values have been reported, our segmentation accuracy matched or exceeded the reported values. The predictions from our models were always better than those predicted by the TotalSegmentator. The sDICE with 2 mm margin was larger than 80% for almost all the structures. Individual structures with decreased segmentation accuracy are analyzed and discussed with respect to their impact on the CTV delineation following the expert guidelines. No deviation is expected to affect the rule-based automation of the CTV delineation.

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Target Volume Delineation Training for Clinical Oncology Trainees: The Role of ARENA and COPP

Cited by 5 publications

References 3 publications

Evaluation of the impact of teaching on delineation variation during a virtual stereotactic ablative radiotherapy contouring workshop

Evaluation of the impact of teaching on delineation variation during a virtual stereotactic ablative radiotherapy contouring workshop

Local Control: Also a Strength of Radiotherapy Training?

Segmentation of 71 Anatomical Structures Necessary for the Evaluation of Guideline-Conforming Clinical Target Volumes in Head and Neck Cancers

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