Variability Among Breast Radiation Oncologists in Delineation of the Postsurgical Lumpectomy Cavity

Landis, Daniel M.; Luo, Weixiu; Song, Jun S.; Bellon, Jennifer R.; Punglia, Rinaa S.; Wong, Julia S.; Killoran, Joseph H.; Gelman, Rebecca; Harris, Jay R.

doi:10.1016/j.ijrobp.2006.11.026

Cited by 199 publications

(142 citation statements)

References 25 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: 59%

“…All imaging datasets were graded for seroma visibility by observer AK using a cavity visualisation score (CVS) which ranges from 1 (cavity invisible) to 5 (cavity borders clearly identifiable) (6). Four anonymised copies were made of each dataset.…”

Section: Imagingmentioning

confidence: 99%

“…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: 59%

Section: Imagingmentioning

confidence: 99%

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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“…Consistency in delineation is crucial in further development of NTCP models for coronary arteries and in the clinical practice to optimize the RT plan for each patient. Several studies have documented significant inter-observer variation in delineation of target volumes and OARs [16][17][18]. One previously published study on reproducibility of delineating coronary arteries showed a substantial inter-observer variation in estimated dose [19].…”

Section: Introductionmentioning

confidence: 99%

Inter-observer variation in delineating the coronary arteries as organs at risk

Wennstig

Garmo

Hållström

et al. 2017

Radiotherapy and Oncology

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PurposeTo determine the inter-observer variation in delineating the coronary arteries as organs at risk (OARs) in breast cancer (BC) radiotherapy (RT) and how this variation affects the estimated coronary artery radiation dose. MethodDelineation of the left main and the left anterior descending coronary artery (LMCA and LAD), and the right coronary artery (RCA), by using the heart atlas by Feng et al, was performed by three radiation oncologists in 32 women who had received adjuvant RT for BC. Centres of the arteries were calculated and distances between artery centres were measured and the artery radiation doses were estimated. The intraclass correlation coefficient (ICC) was used to quantify the variability in doses. ResultsAlong the extent of RCA, the median distance between centres of arteries varied from 2 to 9 mm with similar patterns over pairs of oncologists. For the LMCA-LAD the median distance varied from 1 to 4 mm. The estimated maximum radiation doses showed an ICC variation from 0.82 to 0.97. ConclusionThe coronary arteries can be reliably identified and delineated as OARs in BC RT. The spatial variance is limited and the total variation in radiation dose is almost completely determined by the between patient variation.

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“…This method has shown to inaccurately define the tumor bed and dosimetry is poor (Benda et al, 2003;Landis et al, 2007;Ringash et al 2004) .An ideal method for the delineation of the surgical cavity for the boost volume has not been established (Landis et al, 2007;Ringash et al, 2004). Ultrasound, MRI and CT scans with or without surgical clips are the currently available techniques for identifying the boost volume.…”

Section: Ultrasound Imaging For Tumor Bed Delineationmentioning

confidence: 99%