Evaluation of a target contouring protocol for 3D conformal radiotherapy in non-small cell lung cancer

Senan, Suresh; Koste, John van Sörnsen de; Samson, Michael; Tankink, Hans; Jansen, Peter P.; Nowak, Peter; Krol, Augustinus D.G.; Schmitz, Paul; Lagerwaard, Frank J.

doi:10.1016/s0167-8140(99)00143-7

Cited by 133 publications

(71 citation statements)

References 21 publications

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“…The range of standard deviations of interobserver variations in contoured target volumes determined in the present study was 6.8 to 35.3 cm 3 , agreeing with interobserver variations in PTV with standard deviations ranging from 4.86 to 99.92 cm 3 as reported by Senan et al ( 8 ) for target volumes in lung cancer. A target contouring protocol was designed by Senan et al for multi‐institutional trials to reduce lung target volume variation.…”

Section: Discussionsupporting

confidence: 92%

Dosimetric uncertainties of three‐dimensional dose reconstruction from two‐dimensional data in a multi‐institutional study

Weinberg

Kaurin

Choy

et al. 2004

J Applied Clin Med Phys

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Inconsistencies in the treatment planning process leading to dosimetric uncertainties may affect conclusions drawn from interinstitutional radiation oncology clinical trials. The purpose of this study was to assess the dosimetric uncertainties resulting from the process of reconstructing three‐dimensional dose distributions from two‐dimensional treatment plan information provided by participating institutions in a randomized clinical trial. This study was based on American College of Radiology Protocol #427, Locally Advanced Multi‐Modality Protocol; a multi‐institutional phase II randomized study involving radiation therapy for patients with inoperable non‐small cell lung cancer. Several sources of dosimetric uncertainty were identified and analyzed, including image quality of hard‐copy computed tomography (CT) images, slice spacing of CT scans, treatment position, interpretations of target volumes by radiation oncologists, the contouring of normal anatomic structures, and the use of common beam models for all dose calculations. Each source of uncertainty was investigated using a set of plans, with the ideal characteristics of digital images with 3‐mm axial slice spacing and a flat couch, consisting of eight cases from Vanderbilt University Medical Center with electronically transferred CT data. The target volume DVH values were dependent on the additional uncertainty introduced by differences in delineation of the target volumes by the participating radiation oncologists. The DVH values for the lungs and heart were dependent on image quality and treatment position. Esophagus DVH values were not dependent on any of the sources of uncertainty. None of the structure DVH values were dependent on slice thickness or variations in the contouring of normal anatomic structures. Reconstruction of three‐dimensional dose distributions from two‐dimensional treatment plan information may be useful in cases for which digital CT data is not available or for historical data review. However, dosimetric accuracy will depend on image quality of the treatment planning CT data and consistency in the delineation of tumor volumes.PACS number: 87.53.‐j

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Section: Discussionsupporting

confidence: 92%

Dosimetric uncertainties of three‐dimensional dose reconstruction from two‐dimensional data in a multi‐institutional study

Weinberg

Kaurin

Choy

et al. 2004

J Applied Clin Med Phys

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“…The study methodology, particularly intraobserver variation in contouring, may also contribute to the observed displacements [28] and this may be confounded by the absence of intravenous contrast in ABC scans hampering tumour outlining in or near the mediastinum. The use of rigid manual image registration in the first part of the study could also have introduced a small inaccuracy.…”

Section: Discussionmentioning

confidence: 99%

The Use of the Active Breathing Coordinator Throughout Radical Non–Small-Cell Lung Cancer (NSCLC) Radiotherapy

Brock

McNair

Panakis

et al. 2011

International Journal of Radiation Oncology*Biology*Physics

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“…In these cases, however, delineation of the target volume was based on interpretation of the extent of tumor as displayed in an imaging study and not on the assessment of a particular anatomic structure. Prostate target volumes are notable exceptions, because the target volume is often the entire prostate 7 , 9 , 10 . For these cases, delineation of the target volume is tantamount to delineation of the prostate, and variations in the delineated target volume are the result of different interpretations of the extent of the anatomic structure.…”

Section: Introductionmentioning

confidence: 99%

Assessment of consistency in contouring of normal‐tissue anatomic structures

Collier

Burnett

Amin

et al. 2003

J Applied Clin Med Phys

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The purpose of this work is to estimate the uncertainty in the manual contouring of normal anatomical structures. The heart, esophagus, and spinal cord were contoured manually on six sets of computed tomography images by six dosimetrists whose experience ranged from 1 year to over 15 years. To determine the differences between inter‐ and intraobserver variations, each data set was contoured by one of the dosimetrists five times and once each by the five other dosimetrists. The magnitude of the discrepancies in delineating the contours was assessed. Intradosimetrist contouring discrepancies were as follows: esophagus, average 0.3 cm and maximum 2.9 cm; heart, average 0.5 cm and maximum 7.6 cm; and spinal cord, average 0.1 cm and maximum 0.7 cm. Interdosimetrist contouring discrepancies were as follows: esophagus, average 0.4 cm and maximum 3.1 cm; heart, average 0.7 cm and maximum 8.1 cm; and spinal cord, average 0.2 cm and maximum 0.9 cm. Significant discrepancies can occur when normal anatomic structures are contoured manually. Interdosimetrist discrepancies are typically slightly greater than intradosimetrist discrepancies. The magnitude of the discrepancies does not appear to be correlated to the experience of the dosimetrist. © 2003 American College of Medical Physics.PACS number(s): 87.53.–j, 87.66.–a

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Evaluation of a target contouring protocol for 3D conformal radiotherapy in non-small cell lung cancer

Cited by 133 publications

References 21 publications

Dosimetric uncertainties of three‐dimensional dose reconstruction from two‐dimensional data in a multi‐institutional study

Dosimetric uncertainties of three‐dimensional dose reconstruction from two‐dimensional data in a multi‐institutional study

The Use of the Active Breathing Coordinator Throughout Radical Non–Small-Cell Lung Cancer (NSCLC) Radiotherapy

Assessment of consistency in contouring of normal‐tissue anatomic structures

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