PURPOSE: To assess the variability among clinicians in the delineation of mediastinal and hilar lymph node stations (LNS) according to the published recommendations in the treatment planning of elective nodal irradiation for lung cancer. METHODS: Nine observers delineated on axial CT scans of five cases the LNS according to the guidelines of the published Atlas. Next, the Volumes of Consensus (VC)--fitting strictly the guidelines--for each LNS and case were collectively defined. Volume of Intersection (VI) as the overlap of the Delineated Volume (DV) for each LNS, case and observer with respective VC was computed. The Concordance Index (CI) for respective LNS and observers was defined as "VI/VC x 100%". The Discordance Index (DI) for respective LNS and observers was defined as "(1-VI/VD) x 100%". RESULTS: Mean values of CI and DI for all observers were 69% and 36%, respectively. For five radiation oncologists who used to work as a team the ways of delineation were similar. The poorest reproducibility was shown for LNS 5, 7, 10R, and 10L. CONCLUSIONS: Although detailed guidelines are used there is still substantial room for improvement. More training in the use of the Atlas is recommended.
PURPOSE: To assess the variability among clinicians in the delineation of mediastinal and hilar lymph node stations (LNS) according to the published recommendations in the treatment planning of elective nodal irradiation for lung cancer. METHODS: Nine observers delineated on axial CT scans of five cases the LNS according to the guidelines of the published Atlas. Next, the Volumes of Consensus (VC)--fitting strictly the guidelines--for each LNS and case were collectively defined. Volume of Intersection (VI) as the overlap of the Delineated Volume (DV) for each LNS, case and observer with respective VC was computed. The Concordance Index (CI) for respective LNS and observers was defined as "VI/VC x 100%". The Discordance Index (DI) for respective LNS and observers was defined as "(1-VI/VD) x 100%". RESULTS: Mean values of CI and DI for all observers were 69% and 36%, respectively. For five radiation oncologists who used to work as a team the ways of delineation were similar. The poorest reproducibility was shown for LNS 5, 7, 10R, and 10L. CONCLUSIONS: Although detailed guidelines are used there is still substantial room for improvement. More training in the use of the Atlas is recommended.
Authors: Joris Van de Velde; Tom Vercauteren; Werner De Gersem; Johan Wouters; Katrien Vandecasteele; Philippe Vuye; Frank Vanpachtenbeke; Katharina D'Herde; Ingrid Kerckaert; Wilfried De Neve; Tom Van Hoof Journal: Strahlenther Onkol Date: 2014-04-09 Impact factor: 3.621
Authors: G F Persson; D E Nygaard; C Hollensen; P Munck af Rosenschöld; L S Mouritsen; A K Due; A K Berthelsen; J Nyman; E Markova; A P Roed; H Roed; S Korreman; L Specht Journal: Br J Radiol Date: 2012-09 Impact factor: 3.039
Authors: Daniel L P Holyoake; Maxwell Robinson; Derek Grose; David McIntosh; David Sebag-Montefiore; Ganesh Radhakrishna; Neel Patel; Mike Partridge; Somnath Mukherjee; Maria A Hawkins Journal: Radiother Oncol Date: 2016-08-09 Impact factor: 6.280
Authors: Yatman Tsang; Peter Hoskin; Emiliano Spezi; David Landau; Jason Lester; Elizabeth Miles; John Conibear Journal: Tech Innov Patient Support Radiat Oncol Date: 2019-06-22