Salma K Jabbour1, Sameh A Hashem2, Walter Bosch3, Tae Kyoung Kim4, Steven E Finkelstein5, Bethany M Anderson6, Edgar Ben-Josef7, Christopher H Crane8, Karyn A Goodman9, Michael G Haddock10, Joseph M Herman11, Theodore S Hong12, Lisa A Kachnic13, Harvey J Mamon14, Jason R Pantarotto15, Laura A Dawson16. 1. Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey. Electronic address: jabbousk@cinj.rutgers.edu. 2. Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Ontario, Canada; Department of Radiation Oncology, King Hussein Cancer Center, Amman, Jordan. 3. Department of Radiation Oncology, Washington University School of Medicine, St Louis, Missouri. 4. Department of Medical Imaging, University Health Network, Mount Sinai Hospital and Women's College Hospital, University of Toronto, Toronto, Ontario, Canada. 5. 21st Century Oncology Translational Research Consortium, Scottsdale, Arizona. 6. Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin. 7. Department of Radiation Oncology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania. 8. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas. 9. Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York. 10. Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota. 11. Department of Radiation Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland. 12. Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. 13. Department of Radiation Oncology, Boston University Medical Center, Boston, Massachusetts. 14. Department of Radiation Oncology, Dana-Farber Cancer Institute, and Brigham and Women's Hospital, Boston, Massachusetts. 15. Department of Radiation Oncology, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada. 16. Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Ontario, Canada.
Abstract
PURPOSE: To standardize upper abdominal normal organ contouring guidelines for Radiation Therapy Oncology Group (RTOG) trials. METHODS AND MATERIALS: Twelve expert radiation oncologists contoured the liver, esophagus, gastroesophageal junction (GEJ), stomach, duodenum, and common bile duct (CBD), and reviewed and edited 33 additional normal organ and blood vessel contours on an anonymized patient computed tomography (CT) dataset. Contours were overlaid and compared for agreement using MATLAB (MathWorks, Natick, MA). S95 contours, defined as the binomial distribution to generate 95% group consensus contours, and normal organ contouring definitions were generated and reviewed by the panel. RESULTS: There was excellent consistency and agreement of the liver, duodenal, and stomach contours, with substantial consistency for the esophagus contour, and moderate consistency for the GEJ and CBD contours using a Kappa statistic. Consensus definitions, detailed normal organ contouring recommendations and high-resolution images were developed. CONCLUSIONS: Consensus contouring guidelines and a CT image atlas should improve contouring uniformity in radiation oncology clinical planning and RTOG trials.
PURPOSE: To standardize upper abdominal normal organ contouring guidelines for Radiation Therapy Oncology Group (RTOG) trials. METHODS AND MATERIALS: Twelve expert radiation oncologists contoured the liver, esophagus, gastroesophageal junction (GEJ), stomach, duodenum, and common bile duct (CBD), and reviewed and edited 33 additional normal organ and blood vessel contours on an anonymized patient computed tomography (CT) dataset. Contours were overlaid and compared for agreement using MATLAB (MathWorks, Natick, MA). S95 contours, defined as the binomial distribution to generate 95% group consensus contours, and normal organ contouring definitions were generated and reviewed by the panel. RESULTS: There was excellent consistency and agreement of the liver, duodenal, and stomach contours, with substantial consistency for the esophagus contour, and moderate consistency for the GEJ and CBD contours using a Kappa statistic. Consensus definitions, detailed normal organ contouring recommendations and high-resolution images were developed. CONCLUSIONS: Consensus contouring guidelines and a CT image atlas should improve contouring uniformity in radiation oncology clinical planning and RTOG trials.
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