Evaluation of Dosimetric Consequences of Seroma Contour Variability in Accelerated Partial Breast Irradiation Using a Constructed Representative Seroma Contour

Kosztyla, Robert; Olson, Robert; Carolan, Hannah; Balkwill, Susan; Moiseenko, Vitali; Kwan, Winkle

doi:10.1016/j.ijrobp.2011.11.060

Cited by 18 publications

(16 citation statements)

References 18 publications

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“…Targeting the SC is crucial because, if missed, local control rates may be adversely affected [3,4]. Contouring variability of the SC has important implications for accelerated partial breast irradiation [5].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Magnetic Resonance Imaging and Computed Tomography for Breast Target Volume Delineation in Prone and Supine Positions

Pogson

Delaney

Ahern

et al. 2016

International Journal of Radiation Oncology*Biology*Physics

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Purpose/Objective(s): MRI provides no ionizing radiation dose (allowing inter and intra fraction imaging), improved soft tissue contrast and potentially improved conformity in delineation than CT. This study aimed to determine if T2 weighted magnetic resonance imaging improves seroma cavity (SC) and Whole Breast (WB) inter-observer conformity for radiotherapy purposes compared with the gold standard of CT, both in the prone and supine positions. Results: Imaging modality did not affect inter-observer variation for WB CTVs. Prone WB CTVs were larger in volume and more conformal than Supine CTVs (on both MRI and CT). SC volumes were larger on CT than MRI. SC volumes proved to be comparable in inter-observer conformity in both modalities (VOI of 0.57±0.03 for CT supine, 0.52±0.04 for MR supine, 0.56±0.03 for CT prone and 0.55±0.04 for MR prone) however after registering modalities together the inter-modality variation (DSC of 0.41±0.05 for supine and 0.38±0.04 for prone) was larger than the inter-observer variability for SC despite the location typically remaining constant.Conclusions: MRI inter-observer variation was comparable to CT for the WB CTV and SC delineation, in both prone and supine positions. Whilst the CVS and inter-observer concordance M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT 3 was not significantly higher for MRI than CT, the SCs were smaller on MRI, potentially due to clearer SC definition, especially on T2-weighted MR images.

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Section: Introductionmentioning

confidence: 99%

Comparison of Magnetic Resonance Imaging and Computed Tomography for Breast Target Volume Delineation in Prone and Supine Positions

Pogson

Delaney

Ahern

et al. 2016

International Journal of Radiation Oncology*Biology*Physics

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“…Variation in CTV volumes had an impact on implant dosimetry, which resulted in different treatment volumes among the five observers in the current study. Literature search revealed many studies on interobserver variations [16, 17, 18, 19, 20]. However, limited work has been published for MIB for APBI using open cavity surgery [21].…”

Section: Discussionmentioning

confidence: 99%

“…Variations in delineation of LC and CTV could result in the differences in treatment volumes, and may have impact on dosimetric as well as clinical outcome. Interobserver variability of tumor bed and target delineation for APBI using external beam radiotherapy has been extensively studied [16, 17, 18, 19, 20]; however, the literature available for MIB of breast implants is limited [21]. As per our knowledge, there is no study reporting the impact of interobserver variation in target delineation on irradiated volume.…”

Section: Purposementioning

confidence: 99%

Interobserver variations of target volume delineation and its impact on irradiated volume in accelerated partial breast irradiation with intraoperative interstitial breast implant

Upreti

Budrukkar

Wadasadawala

et al. 2017

jcb

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PurposeTo investigate the interobserver variations in delineation of lumpectomy cavity (LC) and clinical target volume (CTV), and its impact on irradiated volume in accelerated partial breast irradiation using intraoperative multicatheter brachytherapy.Material and methodsDelineation of LC and CTV was done by five radiation oncologists on planning computed tomography (CT) scans of 20 patients with intraoperative interstitial breast implant. Cavity visualization index (CVI), four-point index ranging from (0 = poor) to (3 = excellent) was created and assigned by observers for each patient. In total, 200 contours for all observers and 100 treatment plans were evaluated. Spatial concordance (conformity index, CIcommon, and CIgen), average shift in the center of mass (COM), and ratio of maximum and minimum volumes (Vmax/Vmin) of LC and CTV were quantified among all observers and statistically analyzed. Variation in active dwell positions (0.5 cm step) for each catheter, total reference air kerma (TRAK), volume enclosed by prescription isodose (V100%) among observers and its spatial concordance were analyzed.ResultsThe mean ± SD CIcommon of LC and CTV was 0.54 ± 0.09, and 0.58 ± 0.08, respectively. Conformity index tends to increase, shift in COM and Vmax/Vmin decrease significantly (p < 0.05), as CVI increased. Out of total 309 catheters, 29.8% catheters had no change, 29.8% and 17.5% catheters had variations of 1 and 2 dwell positions (0.5 cm and 1 cm), respectively. 9.3% catheters shown variations ≥ 10 dwell positions (5 cm). The mean ± SD CIcommon of V100% was 0.75 ± 0.11. The mean observed Vmax/Vmin of prescription isodose and TRAK was 1.18 (range, 1.03 to 1.56) and 1.11 (range, 1.03 to 1.35), respectively.ConclusionsInterobserver variability in delineation of target volume was found to be significantly related to CVI. Smaller variability was observed with excellent visualization of LC. Interobserver variations showed dosimetric impact on irradiation of breast tissue volume with prescription dose.

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“…The introduc-tion of various indices for quantitative dosimetric evaluation facilitate to accurately select the best plan [9,10,11]. Several studies have also investigated methods to evaluate the dosimetric impact of interobserver target delineation variability [12,13,14,15]. Few of these brachytherapy studies reported dosimetric impact by generating an optimized reference plan by reference contour and evaluation of various contours by observers [12,13].…”

Section: Purposementioning

confidence: 99%

“…Several studies have also investigated methods to evaluate the dosimetric impact of interobserver target delineation variability [12,13,14,15]. Few of these brachytherapy studies reported dosimetric impact by generating an optimized reference plan by reference contour and evaluation of various contours by observers [12,13]. A study on thoracic tumors treated with external beam radiation therapy evaluated the impact of different plans generated by observer's target volumes on a reference target volume [14].…”

Section: Purposementioning

confidence: 99%

Coverage with dosimetric concordance index (CDCI): a tool for evaluating dosimetric impact of inter-observer target variability in brachytherapy

Upreti

Budrukkar

Upreti

et al. 2020

jcb

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Purpose: The aim of this study was to propose an index for evaluating dosimetric impact of inter-observer target delineation variability in brachytherapy. Material and methods: The coverage with dosimetric concordance index (CDCI) is expressed as CDCI common and CDCI pair. The CDCI common is the mean coverage of target volume with common volume irradiated by prescription dose among all observers and represents the condition of worst target coverage. CDCI pair is the generalized form of CDCI, which is mean target coverage with common prescription volume obtained between all possible pairs of observers and represents more realistic coverage of target with dosimetric concordance. The index was used to evaluate the dosimetric impact of target delineation variability in optimized conformal plans on target volumes of five radiation oncologists for twenty patients of multi-catheter interstitial partial breast brachytherapy. Results: The mean decline of 5.6 ±3.2% and 11.3 ±5.7% in CDCI pair and CDCI common , respectively, was observed comparing to coverage index (CI) of target volume in all patients due to inter-observer target variability. CDCI common and CDCI pair were found to have significant linear correlation (r = 0.964, p < 0.000). The difference between CDC and CI increased with the mean relative target volume among observers. Significant correlation (r = 0.962, p < 0.000) was also noted for the difference (Δ) in CDCI common and CDCI pair with CI of target volume. Conclusions: The recommended indices and difference between the dosimetric coverage of target volume (CI) with CDCI (∆CDCI) can be used for evaluating dosimetric impact of the inter-observer target delineation variability.

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Evaluation of Dosimetric Consequences of Seroma Contour Variability in Accelerated Partial Breast Irradiation Using a Constructed Representative Seroma Contour

Cited by 18 publications

References 18 publications

Comparison of Magnetic Resonance Imaging and Computed Tomography for Breast Target Volume Delineation in Prone and Supine Positions

Comparison of Magnetic Resonance Imaging and Computed Tomography for Breast Target Volume Delineation in Prone and Supine Positions

Interobserver variations of target volume delineation and its impact on irradiated volume in accelerated partial breast irradiation with intraoperative interstitial breast implant

Coverage with dosimetric concordance index (CDCI): a tool for evaluating dosimetric impact of inter-observer target variability in brachytherapy

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