Inter‐scan and inter‐observer tumour volume delineation variability on cone beam computed tomography in patients treated with stereotactic body radiation therapy for early‐stage non‐small cell lung cancer

Hou, Ying; Lee, Stephanie J.; Agrawal, Vishesh; Romano, John; Baldini, Elizabeth H.; Chen, Aileen B.; Kozono, David; Killoran, Joseph H.; Wagar, Matthew; Hacker, Fred; Aerts, Hugo J.W.L.; Lewis, John H.; Mak, Raymond H.

doi:10.1111/1754-9485.12537

Cited by 3 publications

(2 citation statements)

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“… 26 Repeated CBCT before and after each fraction has been proposed to address such a problem as a tool for the target volume monitoring in lung SBRT. 27 The addition of an automated method to delineate the target volume would help to figure out the magnitude of intrafraction and interfraction tumour deformations and the necessity to repeat the planning in case of undesired dosimetric violations, known as adaptive radiation therapy (ART). 28 In the current study, we tested the semi‐automated delineation tool in detecting such variation over repeated CBCTs before and after each fraction and the dosimetric difference that resulted from such variation on D100‐GTV.…”

Section: Discussionmentioning

confidence: 99%

“…It concluded a correlation between a marked reduction in the size during the SBRT in early lung cancer and worse clinical outcomes, progression‐free survival and overall survival 26 . Repeated CBCT before and after each fraction has been proposed to address such a problem as a tool for the target volume monitoring in lung SBRT 27 . The addition of an automated method to delineate the target volume would help to figure out the magnitude of intrafraction and interfraction tumour deformations and the necessity to repeat the planning in case of undesired dosimetric violations, known as adaptive radiation therapy (ART) 28 .…”

Section: Discussionmentioning

confidence: 99%

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Clinical validation of a semi‐automated segmentation algorithm for target volume definition on planning CT and CBCT in stereotactic body radiotherapy (SBRT) for peripheral lung lesions

Mohamed

Risse

Schmitz

et al. 2022

J of Medical Radiation Sci

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Introduction Stereotactic body radiotherapy (SBRT) is an ablative method for lung malignancies. Here, the definition of the gross target volume (GTV) is subject to interobserver variation. In this study, we aimed to evaluate the interobserver variability during SBRT and its dosimetric impact, as well as to introduce a semi‐automated delineation tool for both planning computer tomography (P‐CT) and cone beam CT (CBCT) to help to standardise GTV delineation and adaptive volume‐change registration. Methods The interobserver variation of GTV manual contours from five physicians was analysed in 15 patients after lung SBRT on free breathing (FB) P‐CT ( n = 15) and CBCT ( n = 90) before and after each fraction. The dosimetric impact from interobserver variations of GTV based on the original treatment plan was analysed. Next, the accuracy of an in‐house easy‐to‐use semi‐automated‐segmentation algorithm for pulmonary lesions was compared with gold standard contours in FB P‐CT and CBCT, as well as 4D P‐CT of additional 10 patients. Results The interobserver variability in manual contours resulted in violations of dose coverage of the planning target volume (PTV), which, in turn, resulted in compromised tumour control probability in contours from four physicians. The validation of the semi‐automated delineation algorithm using thorax phantom led to a highly reliable accuracy in defining GTVs. Comparing the unsupervised auto‐contours with the gold standard delineation revealed high equal high concordance for FB P‐CT, 4D P‐CT and CBCT, with a DSC of 0.83, 0.76 and 0.8, respectively. The supervised use of the semi‐automated delineation tool improved its accuracy, with DSCs of 0.86, 0.86 and 0.8 for FB P‐CT, 4D P‐CT and CBCT, respectively. The use of the algorithm was associated with a significantly shorter working time. The semi‐automated delineation tool can accurately register volume changes in CBCTs. Conclusion The segmentation algorithm provides a reliable, standardised and time‐saving alternative for manual delineation in lung SBRT in P‐CT and CBCT.

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Section: Discussionmentioning

confidence: 99%