Clinically oriented contour evaluation using geometric and dosimetric indices based on simple geometric transformations

Abstract

<jats:title>Abstract</jats:title> <jats:p><jats:bold>Background: </jats:bold>In radiotherapy, geometric indices are often used to evaluate the accuracy of contouring; however, the ability of geometric indices to identify the error of contouring results is limited, and they do not consider any clinical background. Based on the reference contouring, we systematically introduced the known geometric errors to study the relationship between geometric indices and dosimetric indices and evaluated the clinical feasibility of assessing the accuracy of contouring based on geometric indices alone.<jats:bold>Materials and Methods: </jats:bold>A C-shaped target, organ at risk (Core), and intensity-modulated radiotherapy (IMRT) plan outlined in the American Association of Physicists in Medicine (AAPM) TG-119 report (The report of Task Group 119 of the AAPM) were used as references. Translation, scaling, rotation (except for the Core), and sine function transformation were performed to simulate the test contours. The corresponding dosimetric indices were obtained from the original dose distribution of the radiotherapy plan, and correlations (R²) between geometric and dosimetric indices were quantified through linear regression. The Wilcoxon signed rank test was used to compare the differences between the geometric indices of three different directions of translation transformations.<jats:bold>Results: </jats:bold>The correlations between the geometric and dosimetric indices were inconsistent for the contouring of the target and Core after the geometric transformation. Except for the sine function transformation (R²: 0.04–0.023, <jats:italic>P</jats:italic> &gt; 0.05), the other geometric transformations of the planning target volume (PTV) had correlations with the dosimetric indices D98% and D<jats:sub>mean</jats:sub> (R²: 0.689–0.988), 80% of which were strongly correlated. The correlation results for the other geometric transformations in the Core were similar to those in the PTV except for the posterior direction transformation. The results of Wilcoxon signed rank test showed that only the <jats:italic>P</jats:italic>-values of volumetric geometric indices of PTV were less than 0.05.<jats:bold>Conclusions: </jats:bold>The dosimetric indices are heavily influenced by the contour differences, thus highlighting their importance in the evaluation process. Clinically, an assessment of the contour accuracy of the region of interest is not feasible based on geometric indices alone, and should be combined with dosimetric indices.</jats:p>