BACKGROUND AND AIM: We aimed to quantify target volume delineation uncertainties in cervix cancer image guided adaptive brachytherapy (IGABT). MATERIALS AND METHODS: Ten radiation oncologists delineated gross tumour volume (GTV), high- and intermediate-risk clinical target volume (HR CTV, IR CTV) in six patients. Their contours were compared with two reference delineations (STAPLE-Simultaneous Truth and Performance Level Estimation and EC- expert consensus) by calculating volumetric and planar conformity index (VCI and PCI) and inter-delineation distances (IDD). RESULTS: VCISTAPLE and VCIEC were 0.76 and 0.72 for HR CTV, 0.77 and 0.68 for IR CTV and 0.59 and 0.58 for GTV. Variation was most prominent caudally and cranially in all target volumes and posterolaterally in IR CTV. IDDSTAPLE and IDDEC for HR CTV (3.6±3.5 and 3.8±3.4 mm) were significantly lower than for GTV (4.8±4.2 and 4.2±3.5 mm) and IR CTV (4.7±5.2 and 5.2±5.6 mm) (p<0.05). CONCLUSIONS: Due to lower delineation uncertainties when compared to GTV and IR CTV, HR CTV may be considered most robust volume for dose prescription and optimization in cervix cancer IGABT. Adequate imaging, training and use of contouring recommendations are main strategies to minimize delineation uncertainties.
BACKGROUND AND AIM: We aimed to quantify target volume delineation uncertainties in cervix cancer image guided adaptive brachytherapy (IGABT). MATERIALS AND METHODS: Ten radiation oncologists delineated gross tumour volume (GTV), high- and intermediate-risk clinical target volume (HR CTV, IR CTV) in six patients. Their contours were compared with two reference delineations (STAPLE-Simultaneous Truth and Performance Level Estimation and EC- expert consensus) by calculating volumetric and planar conformity index (VCI and PCI) and inter-delineation distances (IDD). RESULTS: VCISTAPLE and VCIEC were 0.76 and 0.72 for HR CTV, 0.77 and 0.68 for IR CTV and 0.59 and 0.58 for GTV. Variation was most prominent caudally and cranially in all target volumes and posterolaterally in IR CTV. IDDSTAPLE and IDDEC for HR CTV (3.6±3.5 and 3.8±3.4 mm) were significantly lower than for GTV (4.8±4.2 and 4.2±3.5 mm) and IR CTV (4.7±5.2 and 5.2±5.6 mm) (p<0.05). CONCLUSIONS: Due to lower delineation uncertainties when compared to GTV and IR CTV, HR CTV may be considered most robust volume for dose prescription and optimization in cervix cancer IGABT. Adequate imaging, training and use of contouring recommendations are main strategies to minimize delineation uncertainties.
Authors: Antonio L Damato; Kanopkis Townamchai; Michele Albert; Ryan J Bair; Robert A Cormack; Joanne Jang; Arpad Kovacs; Larissa J Lee; Kimberley S Mak; Kristina L Mirabeau-Beale; Kent W Mouw; John G Phillips; Jennifer L Pretz; Andrea L Russo; John H Lewis; Akila N Viswanathan Journal: Int J Radiat Oncol Biol Phys Date: 2014-05-03 Impact factor: 7.038
Authors: Akila N Viswanathan; Beth Erickson; David K Gaffney; Sushil Beriwal; Sudershan K Bhatia; Omer Lee Burnett; David P D'Souza; Nikhilesh Patil; Michael G Haddock; Anuja Jhingran; Ellen L Jones; Charles A Kunos; Larissa J Lee; Lilie L Lin; Nina A Mayr; Ivy Petersen; Primoz Petric; Lorraine Portelance; William Small; Jonathan B Strauss; Kanokpis Townamchai; Aaron H Wolfson; Catheryn M Yashar; Walter Bosch Journal: Int J Radiat Oncol Biol Phys Date: 2014-10-01 Impact factor: 7.038