E Gkika1, S Tanadini-Lang2, S Kirste3, P A Holzner4, H P Neeff4, H C Rischke3,5, T Reese6, F Lohaus7,8,9,10,11, M N Duma12,13, K Dieckmann14, R Semrau15, M Stockinger16, D Imhoff17,18, N Kremers19, M F Häfner20, N Andratschke2, U Nestle3,21,22,23, A L Grosu3,21,22,23, M Guckenberger2, T B Brunner3,21,22,23. 1. Department of Radiation Oncology, Medical Center - University of Freiburg, Robert-Koch-Str. 3, 79106, Freiburg im Breisgau, Germany. eleni.gkika@uniklinik-freiburg.de. 2. Department of Radiation Oncology, University Hospital Zürich, Zurich, Switzerland. 3. Department of Radiation Oncology, Medical Center - University of Freiburg, Robert-Koch-Str. 3, 79106, Freiburg im Breisgau, Germany. 4. Department of Visceral Surgery, Medical Center - University of Freiburg, Freiburg, Germany. 5. Department of Nuclear Medicine, Medical Center - University of Freiburg, Freiburg, Germany. 6. Department of Radiation Oncology, University Hospital Halle-Wittenberg, Halle-Wittenberg, Germany. 7. Department of Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany. 8. German Cancer Research Center (DKFZ), Heidelberg, Germany. 9. OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany. 10. National Center for Tumor Diseases (NCT), Dresden, Germany. 11. German Cancer Consortium (DKTK) partner site Dresden, Dresden, Germany. 12. Institute of Innovative Radiotherapy, Department of Radiation Sciences, Helmholtz Zentrum Munich, Munich, Germany. 13. Department of Radiation Oncology, Klinikum Rechts der Isar, TU Munich, Munich, Germany. 14. Department of Radiation Oncology, General Hospital Vienna, Medical University Vienna, Vienna, Austria. 15. Department of Radiation Oncology, University Hospital of Cologne, Cologne, Germany. 16. Department of Radiation Oncology, University Hospital Mainz, Mainz, Germany. 17. Department of Radiation Oncology, University Hospital Frankfurt, Frankfurt, Germany. 18. Saphir Radiosurgery Center, Frankfurt, Germany. 19. Department of Radiology, Medical Center - University of Freiburg, Freiburg, Germany. 20. Department of Radiation Oncology, University Hospital Heidelberg, Heidelberg, Germany. 21. Faculty of Medicine, University of Freiburg, Freiburg, Germany. 22. partner site Freiburg, German Cancer Consortium (DKTK), Freiburg, Germany. 23. German cancer Research Center (DKFZ), Heidelberg, Germany.
Abstract
BACKGROUND: Definition of gross tumor volume (GTV) in hepatocellular carcinoma (HCC) requires dedicated imaging in multiple contrast medium phases. The aim of this study was to evaluate the interobserver agreement (IOA) in gross tumor delineation of HCC in a multicenter panel. METHODS: The analysis was performed within the "Stereotactic Radiotherapy" working group of the German Society for Radiation Oncology (DEGRO). The GTVs of three anonymized HCC cases were delineated by 16 physicians from nine centers using multiphasic CT scans. In the first case the tumor was well defined. The second patient had multifocal HCC (one conglomerate and one peripheral tumor) and was previously treated with transarterial chemoembolization (TACE). The peripheral lesion was adjacent to the previous TACE site. The last patient had an extensive HCC with a portal vein thrombosis (PVT) and an inhomogeneous liver parenchyma due to cirrhosis. The IOA was evaluated according to Landis and Koch. RESULTS: The IOA for the first case was excellent (kappa: 0.85); for the second case moderate (kappa: 0.48) for the peripheral tumor and substantial (kappa: 0.73) for the conglomerate. In the case of the peripheral tumor the inconsistency is most likely explained by the necrotic tumor cavity after TACE caudal to the viable tumor. In the last case the IOA was fair, with a kappa of 0.34, with significant heterogeneity concerning the borders of the tumor and the PVT. CONCLUSION: The IOA was very good among the cases were the tumor was well defined. In complex cases, where the tumor did not show the typical characteristics, or in cases with Lipiodol (Guerbet, Paris, France) deposits, IOA agreement was compromised.
BACKGROUND: Definition of gross tumor volume (GTV) in hepatocellular carcinoma (HCC) requires dedicated imaging in multiple contrast medium phases. The aim of this study was to evaluate the interobserver agreement (IOA) in gross tumor delineation of HCC in a multicenter panel. METHODS: The analysis was performed within the "Stereotactic Radiotherapy" working group of the German Society for Radiation Oncology (DEGRO). The GTVs of three anonymized HCC cases were delineated by 16 physicians from nine centers using multiphasic CT scans. In the first case the tumor was well defined. The second patient had multifocal HCC (one conglomerate and one peripheral tumor) and was previously treated with transarterial chemoembolization (TACE). The peripheral lesion was adjacent to the previous TACE site. The last patient had an extensive HCC with a portal vein thrombosis (PVT) and an inhomogeneous liver parenchyma due to cirrhosis. The IOA was evaluated according to Landis and Koch. RESULTS: The IOA for the first case was excellent (kappa: 0.85); for the second case moderate (kappa: 0.48) for the peripheral tumor and substantial (kappa: 0.73) for the conglomerate. In the case of the peripheral tumor the inconsistency is most likely explained by the necrotic tumor cavity after TACE caudal to the viable tumor. In the last case the IOA was fair, with a kappa of 0.34, with significant heterogeneity concerning the borders of the tumor and the PVT. CONCLUSION: The IOA was very good among the cases were the tumor was well defined. In complex cases, where the tumor did not show the typical characteristics, or in cases with Lipiodol (Guerbet, Paris, France) deposits, IOA agreement was compromised.
Authors: Julie K Heimbach; Laura M Kulik; Richard S Finn; Claude B Sirlin; Michael M Abecassis; Lewis R Roberts; Andrew X Zhu; M Hassan Murad; Jorge A Marrero Journal: Hepatology Date: 2018-01 Impact factor: 17.425
Authors: Florian Sterzing; Thomas B Brunner; Iris Ernst; Wolfgang W Baus; Burkhard Greve; Klaus Herfarth; Matthias Guckenberger Journal: Strahlenther Onkol Date: 2014-08-05 Impact factor: 3.621
Authors: Young Suk Kim; Jun Won Kim; Won Sup Yoon; Min Kyu Kang; Ik Jae Lee; Tae Hyun Kim; Jin Hee Kim; Hyung-Sik Lee; Hee Chul Park; Hong Seok Jang; Chul Seung Kay; Sang Min Yoon; Mi-Sook Kim; Jinsil Seong Journal: Strahlenther Onkol Date: 2016-08-18 Impact factor: 3.621
Authors: Theodore S Hong; Walter R Bosch; Sunil Krishnan; Tae K Kim; Harvey J Mamon; Paul Shyn; Edgar Ben-Josef; Jinsil Seong; Michael G Haddock; Jason C Cheng; Mary U Feng; Kevin L Stephans; David Roberge; Christopher Crane; Laura A Dawson Journal: Int J Radiat Oncol Biol Phys Date: 2014-07-15 Impact factor: 7.038