Quality assessment of medical decision making in radiation oncology: variability in target volume delineation for brain tumours

Leunens, G.; Menten, Johan; Weltens, Caroline; Verstraete, J.; Schueren, Emmanuel van der

doi:10.1016/0167-8140(93)90243-2

Cited by 138 publications

(64 citation statements)

References 21 publications

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“…Following 3-D planning, differences in the magnitude of GTVs between 35 and 59% of the respective maximum volumes were found [45]. This variation should be compared to the results obtained in a (2-D) simulation film-based study by Leunens et al [20]. The authors compared the projection of the tumor and target volumes on the simulation images of five brain tumor patients.…”

Section: Review Of the Literaturementioning

confidence: 99%

The Impact of Gross Tumor Volume (GTV) and Clinical Target Volume (CTV) Definition on the Total Accuracy in Radiotherapy

Weiss¹,

2003

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Section: Review Of the Literaturementioning

confidence: 99%

The Impact of Gross Tumor Volume (GTV) and Clinical Target Volume (CTV) Definition on the Total Accuracy in Radiotherapy

Weiss¹,

2003

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“…Delineating treatment targets within DICOM files is complex, operator-dependent, and critical to the accurate delivery of conformal radiotherapy [11][12][13][14][15]. These variabilities in target volume delineation can be a major primary source of inaccuracy of dose delivery and treatment errors [16].…”

Section: Discussionmentioning

confidence: 99%

Human–Computer Interaction in Radiotherapy Target Volume Delineation: A Prospective, Multi-institutional Comparison of User Input Devices

et al. 2010

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The purpose of this study was the prospective comparison of objective and subjective effects of target volume region of interest (ROI) delineation using mousekeyboard and pen-tablet user input devices (UIDs). The study was designed as a prospective test/retest sequence, with Wilcoxon signed rank test for matchedpair comparison. Twenty-one physician-observers contoured target volume ROIs on four standardized cases (representative of brain, prostate, lung, and head and neck malignancies) twice: once using QWERTY keyboard/scroll-wheel mouse UID and once with pen-tablet UID (DTX2100, Wacom Technology Corporation, Vancouver, WA, USA). Active task time, ROI manipulation task data, and subjective survey data were collected. One hundred twenty-nine target volume ROI sets were collected, with 62 paired pen-tablet/mouse-keyboard sessions. Active contouring time was reduced using the pen-tablet UID, with mean ± SD active contouring time of 26 ±23 min, compared with 32 ± 25 with the mouse (p ≤ 0.01). Subjective estimation of time spent was also reduced from 31 ±26 with mouse to 27 ± 22 min with the pen (p = 0.02). Task analysis showed ROI correction task reduction (p = 0.045) and decreased panning and scrolling tasks (p < 0.01) with the pen-tablet; drawing, window/ level changes, and zoom commands were unchanged (p = n.s.) Volumetric analysis demonstrated no detectable differences in ROI volume nor intra-or inter-observer volumetric coverage. Fifty-two of 62 (84%) users preferred the tablet for each contouring task; 5 of 62 (8%) denoted no preference, and 5 of 62 (8%) chose the mouse interface. The pen-tablet UID reduced active contouring time and reduced correction of ROIs, without substantially altering ROI volume/coverage.

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“…Many investigations have been perfollned to determine the variability in hunor delineation, especially for prostate cancer. Local differences between physicians or between the same physician at different times can exceed I cm [24,37,68,100,115,131).…”

Section: Delilleatioll Iil/certail/ty Reductiollmentioning

confidence: 99%

Safety margins for geometrical uncertainties in radiotherapy

Stroom

2000

Med. Phys.

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In this thesis we deal with the calculation and minimization of safety margins (CTV to PTV) that are required to account for setup errors and internal organ motion in radiotherapy. First of all, an algorithm was developed to automatically expand a three‐dimensional (3‐D) tumor volume, defined in a set of 2‐D CT images, with 3‐D margins of a given size. To do this manually and in three dimensions is impossible. The clinical advantages of the automatically calculated 3‐D margins over the much applied manual 2‐D expansion procedure were assessed. In addition, a model was devised to calculate the margins using measured geometrical deviations from the planned situation in representative patient populations. The calculated margins were such that the expected radiation dose in the tumor was adequate and homogeneous. It appeared that systematic deviations, which are the same each fraction of the treatment, are about three times more important than random deviations, which vary from fraction to fraction. The model was used to investigate whether smaller margins could be used when patients with prostate cancer are treated in the prone instead of the supine position, but there was no significant difference. Finally, the use of portal images for an on‐line correction of geometrical deviations was studied. The registration of bony structures in the images enabled on‐line corrections of the patient setup within a couple of minutes and a significant margin reduction. For prostate cancer treatments, simulations using multiple CT data of 15 patients indicated that gas pockets in the rectum, which are also visible in portal images, may be used for the on‐line determination of rectal wall and tumor motion.

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Quality assessment of medical decision making in radiation oncology: variability in target volume delineation for brain tumours

Cited by 138 publications

References 21 publications

The Impact of Gross Tumor Volume (GTV) and Clinical Target Volume (CTV) Definition on the Total Accuracy in Radiotherapy

The Impact of Gross Tumor Volume (GTV) and Clinical Target Volume (CTV) Definition on the Total Accuracy in Radiotherapy

Human–Computer Interaction in Radiotherapy Target Volume Delineation: A Prospective, Multi-institutional Comparison of User Input Devices

Safety margins for geometrical uncertainties in radiotherapy

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