Impact of inter-observer variations in target volume delineation on dose volume indices for accelerated partial breast irradiation with multi-catheter interstitial brachytherapy

Upreti, Ritu Raj; Budrukkar, Ashwini; Upreti, Udita; Wadasadawala, Tabassum; Misra, Shagun; Gurram, Lavanya; Pathak, Rima; Deshpande, Deepak D.

doi:10.1016/j.radonc.2018.06.029

Cited by 8 publications

(6 citation statements)

References 26 publications

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“…The ΔCDC tends to increase when the relative PTV volume (RPV) among observers increases. This is due to a decrease in the CI of PTV when the RPV increases, as shown in our previous publication [16]. Larger PTV volumes had poorer dosimetric coverage and therefore greater percentage reduction in both the indices with CI of PTV.…”

Section: Discussionsupporting

confidence: 68%

“…Despite these studies, there is no known index to evaluate and quantify the dosimetric impact of inter-observer variability. Therefore, in our study, we proposed an index called "coverage with dosimetric concordance index" (CDCI), based on the results of our extensive work on inter-observer variability [16,17].…”

Section: Purposementioning

confidence: 99%

“…For this study, we analyzed the data of our previously published work [16]. Twenty breast cancer patients, suitable for APBI, underwent flexible nylon tube interstitial implant using the open cavity technique.…”

Section: Target Delineation and Treatment Planningmentioning

confidence: 99%

“…Inter-observer target delineation variability among five observers on the CT scan of twenty patients was investigated and reported previously [17]. One hundred optimized conformal plans were subsequently generated by a single planner on the clinical target volumes (CTV's) delineated by five radiation oncologists (observers) on twenty patients treated with multi-catheter interstitial partial breast brachytherapy (MIB) in Oncentra brachytherapy planning (Oncentra v 4.3, Elekta AB, Stockholm, Sweden) [16,17]. For brachytherapy, CTV was considered as PTV.…”

Section: Target Delineation and Treatment Planningmentioning

confidence: 99%

“…Each plan (A1) was graphically optimized to individual target volume contoured by an observer (A) to get maximum coverage of target volume with prescription dose. The goal of the treatment planning was to achieve target volume coverage of ≥ 80% and dose homogeneity index (DHI) ≥ 0.75 [16]. As the MIB was delivered within 3 days of lumpectomy at our institution, an underdose was observed and clinically accepted to the target volume in the region close to the skin with an air pocket.…”

Section: Target Delineation and Treatment Planningmentioning

confidence: 99%

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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

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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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Section: Discussionsupporting

confidence: 68%

Section: Purposementioning

confidence: 99%

Section: Target Delineation and Treatment Planningmentioning

confidence: 99%