Development of delineation for the left anterior descending coronary artery region in left breast cancer radiotherapy: An optimized organ at risk

Lee, Jie; Hua, Kai; Hsu, Shih Ming; Lin, Joseph; Lee, Chou Hsien; Lu, K.W.; Keino, Dai; Huang, Xu Nian; Hashimoto, Jun; Wu, Mei-Han; Chen, Yu-Jen

doi:10.1016/j.radonc.2016.12.029

Cited by 35 publications

(27 citation statements)

References 30 publications

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“…Regarding the single OAR (Table 2), the LAD presented the largest variability of contouring probably due to the small volume and the difficulty of visualization and identification on the CT imaging, especially without any contrast medium [31]. Similarly, the oesophagus faced the same challenge of being identified along the entire length and presented a borderline DSC.…”

Section: Discussionmentioning

confidence: 99%

The emerging role of radiation therapists in the contouring of organs at risk in radiotherapy: analysis of inter-observer variability with radiation oncologists for the chest and upper abdomen

Arculeo

Miglietta

Nava

et al. 2020

ecancer

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Aims: To compare the contouring of organs at risk (OAR) between a clinical specialist radiation therapist (CSRT) and radiation oncologists (ROs) with different levels of expertise (senior-SRO, junior-JRO, fellow-FRO). Methods: On ten planning computed tomography (CT) image sets of patients undergoing breast radiotherapy (RT), the observers independently contoured the contralateral breast, heart, left anterior descending artery (LAD), oesophagus, kidney, liver, spinal cord, stomach and trachea. The CSRT was instructed by the JRO e SRO. The inter-observer variability of contoured volumes was measured using the Dice similarity coefficient (DSC) (threshold of ≥ 0.7 for good concordance) and the centre of mass distance (CMD). The analysis of variance (ANOVA) was performed and a p-value < 0.01 was considered statistically significant. Results: Good overlaps (DSC > 0.7) were obtained for all OARs, except for LAD (DSC = 0.34 ± 0.17, mean ± standard deviation) and oesophagus (DSC = 0.66 ± 0.06, mean ± SD). The mean CMD < 1 cm was achieved for all the OARs, but spinal cord (CMD = 1.22 cm). By pairing the observers, mean DSC > 0.7 and mean CMD < 1 cm were achieved in all cases. The best overlaps were seen for the pairs JRO-CSRT(DSC = 0.82; CMD = 0.49 cm) and SRO-JRO (DSC = 0.80; CMD = 0.51 cm). Conclusions: Overall, good concordance was found for all the observers. Despite the short training in contouring, CSRT obtained good concordance with his tutor (JRO). Great variability was seen in contouring the LAD, due to its difficult visualization and identification of CT scans without contrast.

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Section: Discussionmentioning

confidence: 99%

The emerging role of radiation therapists in the contouring of organs at risk in radiotherapy: analysis of inter-observer variability with radiation oncologists for the chest and upper abdomen

Arculeo

Miglietta

Nava

et al. 2020

ecancer

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“…The outlining of the coronary vessels shows significant inter-observer variation that may jeopardize dose verification in the selected position [35,36]. Different approaches have been tested to improve consistency including the administration of contrast media [35][36][37]. Lee et al developed a new protocol to outline the LAD region which included 96% of the LAD volume as delineated by 4 experienced radiation oncologists [37].…”

Section: Gyheartmentioning

confidence: 99%

“…Different approaches have been tested to improve consistency including the administration of contrast media [35][36][37]. Lee et al developed a new protocol to outline the LAD region which included 96% of the LAD volume as delineated by 4 experienced radiation oncologists [37]. Significant impact was made by the implementation of specific guidelines [35][36][37].…”

Section: Gyheartmentioning

confidence: 99%

“…Lee et al developed a new protocol to outline the LAD region which included 96% of the LAD volume as delineated by 4 experienced radiation oncologists [37]. Significant impact was made by the implementation of specific guidelines [35][36][37]. Since the utility of the simple tool might be influenced by several factors, in addition to the use of institutional LAD contouring guidelines and study of inter-observer variation, we consider essential its testing before routine use.…”

Section: Gyheartmentioning

confidence: 99%

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A simple clinical method for predicting the benefit of prone vs. supine positioning in reducing heart exposure during left breast radiotherapy

Kahán

Rárosi

Gaál

et al. 2018

Radiotherapy and Oncology

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“…[16,71]. Different approaches have been tested to improve consistency including the administration of contrast media [16,71,72]. Lee et al…”

Section: A Simple Clinical Methods For Predicting the Benefit Of Pronementioning

confidence: 99%

Individualised radiotherapy serving reduced toxicity in breast and prostate cancer

Kószó¹

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The presence of normal tissues in the irradiated volume limits dose escalation during pelvic radiotherapy (RT) for prostate cancer. Supine and prone positions on a belly board were compared by analyzing the exposure of organs at risk (OARs) using intensity modulated RT (IMRT). The prospective trial included 55 high risk, localized or locally advanced prostate cancer patients, receiving definitive image-guided RT. Computed tomography scanning for irradiation planning was carried out in both positions. Gross tumor volume, clinical and planning target volumes (PTV) and OARs were delineated, defining subprostatic and periprostatic rectal subsegments. At the height of the largest antero-posterior (AP) diameter of the prostate, rectal diameters and distance from the posterior prostate wall were measured. IMRT plans were generated. Normal tissue exposure and structure volumes were compared between supine and prone plans using paired t-test. In the volumes of the prostate, PTV, colon and small bowel, no significant differences were found. In prone position, all rectal volumes, diameters, and rectum-prostate distance were significantly higher, the irradiated colon and small bowel volume was lower in dose ranges of 20-40 Gy, and the exposure to all rectal segments was more favorable in 40-75 Gy dose ranges. No significant difference was found in the exposure of other OARs. Prone positioning on a belly board is an appropriate positioning method aiming rectum and bowel protection during pelvic IMRT of prostate cancer. The relative reduction in rectal exposure might be a consequence of the slight departure between the prostate and rectal wall.

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Development of delineation for the left anterior descending coronary artery region in left breast cancer radiotherapy: An optimized organ at risk

Cited by 35 publications

References 30 publications

The emerging role of radiation therapists in the contouring of organs at risk in radiotherapy: analysis of inter-observer variability with radiation oncologists for the chest and upper abdomen

The emerging role of radiation therapists in the contouring of organs at risk in radiotherapy: analysis of inter-observer variability with radiation oncologists for the chest and upper abdomen

A simple clinical method for predicting the benefit of prone vs. supine positioning in reducing heart exposure during left breast radiotherapy

Individualised radiotherapy serving reduced toxicity in breast and prostate cancer

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