Eliana La Rocca1,2, Vanessa Lici2, Tommaso Giandini3, Francesca Bonfantini3, Sarah Frasca1, Michela Dispinzieri1,2, Massimiliano Gennaro4, Di Cosimo S, Serena Di Cosimo5, Laura Lozza1, Emanuele Pignoli3, Riccardo Valdagni2,6, Maria Carmen De Santis1. 1. 1 Radiotherapy Unit 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. 2. 2 Department of Oncology and Hemato-oncology, Università degli Studi di Milano, Milan, Italy. 3. 3 Medical Physics Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. 4. 4 Breast Surgery Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. 5. 5 Department of Applied Research and Technological Development (DRAST), Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. 6. 6 Radiation Oncology 1 and Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Abstract
PURPOSE: To examine interobserver variability between the radiation oncologist (RTO) and the radiation therapist (RTT) in delineating the tumor bed (TB) in early breast cancer (BC). METHODS: We retrospectively analyzed patients who received a radiotherapy boost to the TB. In a first group, the clinical target volume (CTV) for the boost was the surgical bed, defined by using surgical clips. In a second group, the CTV was defined by identifying a seroma cavity or a metallic find on the scar. These contours were compared in terms of volume, number of slices, and Dice similarity coefficient (DSC). RESULTS: Forty patients were assessed: 20 had surgical clips (group 1) while the other 20 had none (group 2). There was no difference in the number of slices contoured by the 2 operators for group 1, but a statistically significant difference emerged in the volumes: the RTT identified a TB that was a mean 45% smaller than the one identified by the RTO. Random differences were found between the 2 operators for group 2. The TBs delineated for this group were significantly larger (P<0.05) than those identified by the RTT for group 1. The mean Dice value between the RTO's and the RTT's TBs was 0.69±0.07 (range 0.53-0.81) for group 1 and 0.37±0.18 (range 0-0.58) for group 2 (P<0.05). CONCLUSIONS: This study showed that the use of clips coincided with less interoperator variability. With appropriate training, the RTT may play an important part in the multidisciplinary radiotherapy team.
PURPOSE: To examine interobserver variability between the radiation oncologist (RTO) and the radiation therapist (RTT) in delineating the tumor bed (TB) in early breast cancer (BC). METHODS: We retrospectively analyzed patients who received a radiotherapy boost to the TB. In a first group, the clinical target volume (CTV) for the boost was the surgical bed, defined by using surgical clips. In a second group, the CTV was defined by identifying a seroma cavity or a metallic find on the scar. These contours were compared in terms of volume, number of slices, and Dice similarity coefficient (DSC). RESULTS: Forty patients were assessed: 20 had surgical clips (group 1) while the other 20 had none (group 2). There was no difference in the number of slices contoured by the 2 operators for group 1, but a statistically significant difference emerged in the volumes: the RTT identified a TB that was a mean 45% smaller than the one identified by the RTO. Random differences were found between the 2 operators for group 2. The TBs delineated for this group were significantly larger (P<0.05) than those identified by the RTT for group 1. The mean Dice value between the RTO's and the RTT's TBs was 0.69±0.07 (range 0.53-0.81) for group 1 and 0.37±0.18 (range 0-0.58) for group 2 (P<0.05). CONCLUSIONS: This study showed that the use of clips coincided with less interoperator variability. With appropriate training, the RTT may play an important part in the multidisciplinary radiotherapy team.
Entities:
Keywords:
Breast cancer; interobserver variability; surgical clips; tumor bed delineation
Authors: D Piro; L Boldrini; P Cornacchione; C Votta; M Bianchi; M Balducci; M A Gambacorta; V Valentini; D Pasini Journal: Tech Innov Patient Support Radiat Oncol Date: 2020-06-20
Authors: Marnix J A Rasing; Gonda G Sikkes; Nicole G P M Vissers; Alexis N T J Kotte; Joske H Boudewijn; Patricia A H Doornaert; Wietse S C Eppinga; Martijn Intven; Reijer H A Rutgers; Annick Scheeren; Louk M W Snoeren; Tiny B Vlig; Jochem R N van der Voort van Zyp; Lisa M Wijkhuizen; Peter S N van Rossum; Max Peters; Ina M Jürgenliemk-Schulz Journal: Tech Innov Patient Support Radiat Oncol Date: 2022-08-24