Dale Roach1,2, Lois C Holloway1,2,3,4, Michael G Jameson1,2,3,4, Jason A Dowling1,3,5,6, Angel Kennedy7, Peter B Greer6,8, Michele Krawiec7, Robba Rai1,2,4, Jim Denham9, Jeremiah De Leon10, Karen Lim4,11, Megan E Berry4,11, Rohen T White7, Sean A Bydder7, Hendrick T Tan7, Jeremy D Croker12, Alycea McGrath7, John Matthews13, Robert J Smeenk14, Martin A Ebert3,7,15. 1. Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia. 2. Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia. 3. Centre for Medical Radiation Physics, University of Wollongong, Wollongong, New South Wales, Australia. 4. Department of Radiation Oncology, Liverpool and Macarthur Cancer Therapy Centres, New South Wales, Australia. 5. Australian e-Health Research Centre, CSIRO, Royal Brisbane Hospital, Brisbane, Queensland, Australia. 6. School of Mathematical and Physical Sciences, University of Newcastle, Newcastle, New South Wales, Australia. 7. Radiation Oncology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia. 8. Calvary Mater Newcastle Hospital, Newcastle, New South Wales, Australia. 9. School of Medicine and Population Health, University of Newcastle, Newcastle, New South Wales, Australia. 10. Illawarra Cancer Care Centre, Wollongong, New South Wales, Australia. 11. South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia. 12. Fiona Stanley Hospital, Perth, Western Australia, Australia. 13. Radiation Oncology, Auckland City Hospital, Auckland, New Zealand. 14. Department of Radiation Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands. 15. School of Physics and Astrophysics, Faculty of Science, University of Western Australia, Perth, Western Australia, Australia.
Abstract
INTRODUCTION: This study quantified inter-observer contouring variations for multiple male pelvic structures, many of which are of emerging relevance for prostate cancer radiotherapy progression and toxicity response studies. METHODS: Five prostate cancer patient datasets (CT and T2-weighted MR) were distributed to 13 observers for contouring. CT structures contoured included the clinical target volume (CTV), seminal vesicles, rectum, colon, bowel bag, bladder and peri-rectal space (PRS). MR contours included CTV, trigone, membranous urethra, penile bulb, neurovascular bundle and multiple pelvic floor muscles. Contouring variations were assessed using the intraclass correlation coefficient (ICC), Dice similarity coefficient (DSC), and multiple additional metrics. RESULTS: Clinical target volume (CT and MR), bladder, rectum and PRS contours showed excellent inter-observer agreement (median ICC = 0.97; 0.99; 1.00; 0.95; 0.90, DSC = 0.83 ± 0.05; 0.88 ± 0.05; 0.93 ± 0.03; 0.81 ± 0.07; 0.80 ± 0.06, respectively). Seminal vesicle contours were more variable (ICC = 0.75, DSC = 0.73 ± 0.14), while colon and bowel bag contoured volumes were consistent (ICC = 0.97; 0.97), but displayed poor overlap (DSC = 0.58 ± 0.22; 0.67 ± 0.21). Smaller MR structures showed significant inter-observer variations, with poor overlap for trigone, membranous urethra, penile bulb, and left and right neurovascular bundles (DSC = 0.44 ± 0.22; 0.41 ± 0.21; 0.66 ± 0.21; 0.16 ± 0.17; 0.15 ± 0.15). Pelvic floor muscles recorded moderate to strong inter-observer agreement (ICC = 0.50-0.97), although large outlier variations were observed. CONCLUSIONS: Inter-observer contouring variation was significant for multiple pelvic structures contoured on MR.
INTRODUCTION: This study quantified inter-observer contouring variations for multiple male pelvic structures, many of which are of emerging relevance for prostate cancer radiotherapy progression and toxicity response studies. METHODS: Five prostate cancerpatient datasets (CT and T2-weighted MR) were distributed to 13 observers for contouring. CT structures contoured included the clinical target volume (CTV), seminal vesicles, rectum, colon, bowel bag, bladder and peri-rectal space (PRS). MR contours included CTV, trigone, membranous urethra, penile bulb, neurovascular bundle and multiple pelvic floor muscles. Contouring variations were assessed using the intraclass correlation coefficient (ICC), Dice similarity coefficient (DSC), and multiple additional metrics. RESULTS: Clinical target volume (CT and MR), bladder, rectum and PRS contours showed excellent inter-observer agreement (median ICC = 0.97; 0.99; 1.00; 0.95; 0.90, DSC = 0.83 ± 0.05; 0.88 ± 0.05; 0.93 ± 0.03; 0.81 ± 0.07; 0.80 ± 0.06, respectively). Seminal vesicle contours were more variable (ICC = 0.75, DSC = 0.73 ± 0.14), while colon and bowel bag contoured volumes were consistent (ICC = 0.97; 0.97), but displayed poor overlap (DSC = 0.58 ± 0.22; 0.67 ± 0.21). Smaller MR structures showed significant inter-observer variations, with poor overlap for trigone, membranous urethra, penile bulb, and left and right neurovascular bundles (DSC = 0.44 ± 0.22; 0.41 ± 0.21; 0.66 ± 0.21; 0.16 ± 0.17; 0.15 ± 0.15). Pelvic floor muscles recorded moderate to strong inter-observer agreement (ICC = 0.50-0.97), although large outlier variations were observed. CONCLUSIONS: Inter-observer contouring variation was significant for multiple pelvic structures contoured on MR.
Authors: Thomas Willigenburg; Daan M de Muinck Keizer; Max Peters; An Claes; Jan J W Lagendijk; Hans C J de Boer; Jochem R N van der Voort van Zyp Journal: Clin Transl Radiat Oncol Date: 2021-01-14
Authors: F R Teunissen; R C Wortel; F J Wessels; A Claes; S M G van de Pol; M J A Rasing; R P Meijer; H H E van Melick; J C J de Boer; H M Verkooijen; J R N van der Voort van Zyp Journal: Clin Transl Radiat Oncol Date: 2021-11-14
Authors: Frederik R Teunissen; Jochem R N van der Voort van Zyp; Eline N de Groot-van Breugel; Helena M Verkooijen; Ruud C Wortel; Johannes C J de Boer Journal: Phys Imaging Radiat Oncol Date: 2022-09-13