Prostate tumor delineation using multiparametric magnetic resonance imaging: Inter-observer variability and pathology validation

Peter Steenbergen; Karin Haustermans; Evelyne Lerut; Raymond Oyen; Liesbeth De Weyer; Laura Van den Bergh; LGW Kerkmeijer; FA Pameijer; WB Veldhuis; Jochem van der Voort van Zyp; Floris J. Pos; Stijn W. Heijmink; Robin Kalisvaart; Hendrik J. Teertstra; Cuong V. Dinh; Ghazaleh Ghobadi; Uulke A. van der Heide

doi:10.1016/j.radonc.2015.04.012

Prostate tumor delineation using multiparametric magnetic resonance imaging: Inter-observer variability and pathology validation

Peter Steenbergen, Karin Haustermans, Evelyne Lerut, Raymond Oyen, Liesbeth De Weyer, Laura Van den Bergh, LGW Kerkmeijer, FA Pameijer, WB Veldhuis, Jochem van der Voort van Zyp, Floris J. Pos, Stijn W. Heijmink, Robin Kalisvaart, Hendrik J. Teertstra, Cuong V. Dinh, Ghazaleh Ghobadi, Uulke A. van der Heide^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Background and purpose: Boosting the dose to the largest (dominant) lesion in radiotherapy of prostate cancer may improve treatment outcome. The success of this approach relies on the detection and delineation of tumors. The agreement among teams of radiation oncologists and radiologists delineating lesions on multiparametric magnetic resonance imaging (mp-MRI) was assessed by measuring the distances between observer contours. The accuracy of detection and delineation was determined using whole-mount histopathology specimens as reference.

Material and methods: Six observer teams delineated tumors on mp-MRI of 20 prostate cancer patients who underwent a prostatectomy. To assess the inter-observer agreement, the inter-observer standard deviation (SD) of the contours was calculated for tumor sites which were identified by all teams.

Results: Eighteen of 89 lesions were identified by all teams, all were dominant lesions. The median histological volume of these was 2.4 cm(3). The median inter-observer SD of the delineations was 0.23 cm. Sixty-six of 69 satellites were missed by all teams.

Conclusion: Since all teams identify most dominant lesions, dose escalation to the dominant lesion is feasible. Sufficient dose to the whole prostate may need to be maintained to prevent under treatment of smaller lesions and undetected parts of larger lesions. (C) 2015 The Authors. Published by Elsevier Ireland Ltd.

Original language	English
Pages (from-to)	186-190
Number of pages	5
Journal	Radiotherapy & Oncology
Volume	115
Issue number	2
DOIs	https://doi.org/10.1016/j.radonc.2015.04.012
Publication status	Published - May 2015

Keywords

Prostate cancer
Radiotherapy
Tumor delineation
Multiparametric MRI
Dose escalation
Inter-observer variability
WHOLE-MOUNT HISTOPATHOLOGY
SIMULTANEOUS INTEGRATED BOOST
CANCER
MRI
THERAPY
RADIOTHERAPY
METAANALYSIS
PARAMETERS
LESIONS

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10.1016/j.radonc.2015.04.012

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Steenbergen, P., Haustermans, K., Lerut, E., Oyen, R., De Weyer, L., Van den Bergh, L., Kerkmeijer, LGW., Pameijer, FA., Veldhuis, WB., van der Voort van Zyp, J., Pos, F. J., Heijmink, S. W., Kalisvaart, R., Teertstra, H. J., Dinh, C. V., Ghobadi, G., & van der Heide, U. A. (2015). Prostate tumor delineation using multiparametric magnetic resonance imaging: Inter-observer variability and pathology validation. Radiotherapy & Oncology, 115(2), 186-190. https://doi.org/10.1016/j.radonc.2015.04.012

@article{26845f8dd1ef4487a86bd334fd4df81e,

title = "Prostate tumor delineation using multiparametric magnetic resonance imaging: Inter-observer variability and pathology validation",

abstract = "Background and purpose: Boosting the dose to the largest (dominant) lesion in radiotherapy of prostate cancer may improve treatment outcome. The success of this approach relies on the detection and delineation of tumors. The agreement among teams of radiation oncologists and radiologists delineating lesions on multiparametric magnetic resonance imaging (mp-MRI) was assessed by measuring the distances between observer contours. The accuracy of detection and delineation was determined using whole-mount histopathology specimens as reference.Material and methods: Six observer teams delineated tumors on mp-MRI of 20 prostate cancer patients who underwent a prostatectomy. To assess the inter-observer agreement, the inter-observer standard deviation (SD) of the contours was calculated for tumor sites which were identified by all teams.Results: Eighteen of 89 lesions were identified by all teams, all were dominant lesions. The median histological volume of these was 2.4 cm(3). The median inter-observer SD of the delineations was 0.23 cm. Sixty-six of 69 satellites were missed by all teams.Conclusion: Since all teams identify most dominant lesions, dose escalation to the dominant lesion is feasible. Sufficient dose to the whole prostate may need to be maintained to prevent under treatment of smaller lesions and undetected parts of larger lesions. (C) 2015 The Authors. Published by Elsevier Ireland Ltd.",

keywords = "Prostate cancer, Radiotherapy, Tumor delineation, Multiparametric MRI, Dose escalation, Inter-observer variability, WHOLE-MOUNT HISTOPATHOLOGY, SIMULTANEOUS INTEGRATED BOOST, CANCER, MRI, THERAPY, RADIOTHERAPY, METAANALYSIS, PARAMETERS, LESIONS",

author = "Peter Steenbergen and Karin Haustermans and Evelyne Lerut and Raymond Oyen and {De Weyer}, Liesbeth and {Van den Bergh}, Laura and LGW Kerkmeijer and FA Pameijer and WB Veldhuis and {van der Voort van Zyp}, Jochem and Pos, {Floris J.} and Heijmink, {Stijn W.} and Robin Kalisvaart and Teertstra, {Hendrik J.} and Dinh, {Cuong V.} and Ghazaleh Ghobadi and {van der Heide}, {Uulke A.}",

year = "2015",

month = may,

doi = "10.1016/j.radonc.2015.04.012",

language = "English",

volume = "115",

pages = "186--190",

journal = "Radiotherapy & Oncology",

issn = "0167-8140",

publisher = "Elsevier Ireland Ltd",

number = "2",

}

Steenbergen, P, Haustermans, K, Lerut, E, Oyen, R, De Weyer, L, Van den Bergh, L, Kerkmeijer, LGW, Pameijer, FA, Veldhuis, WB , van der Voort van Zyp, J, Pos, FJ, Heijmink, SW, Kalisvaart, R, Teertstra, HJ, Dinh, CV, Ghobadi, G & van der Heide, UA 2015, 'Prostate tumor delineation using multiparametric magnetic resonance imaging: Inter-observer variability and pathology validation', Radiotherapy & Oncology, vol. 115, no. 2, pp. 186-190. https://doi.org/10.1016/j.radonc.2015.04.012

TY - JOUR

T1 - Prostate tumor delineation using multiparametric magnetic resonance imaging

T2 - Inter-observer variability and pathology validation

AU - Steenbergen, Peter

AU - Haustermans, Karin

AU - Lerut, Evelyne

AU - Oyen, Raymond

AU - De Weyer, Liesbeth

AU - Van den Bergh, Laura

AU - Kerkmeijer, LGW

AU - Pameijer, FA

AU - Veldhuis, WB

AU - van der Voort van Zyp, Jochem

AU - Pos, Floris J.

AU - Heijmink, Stijn W.

AU - Kalisvaart, Robin

AU - Teertstra, Hendrik J.

AU - Dinh, Cuong V.

AU - Ghobadi, Ghazaleh

AU - van der Heide, Uulke A.

PY - 2015/5

Y1 - 2015/5

N2 - Background and purpose: Boosting the dose to the largest (dominant) lesion in radiotherapy of prostate cancer may improve treatment outcome. The success of this approach relies on the detection and delineation of tumors. The agreement among teams of radiation oncologists and radiologists delineating lesions on multiparametric magnetic resonance imaging (mp-MRI) was assessed by measuring the distances between observer contours. The accuracy of detection and delineation was determined using whole-mount histopathology specimens as reference.Material and methods: Six observer teams delineated tumors on mp-MRI of 20 prostate cancer patients who underwent a prostatectomy. To assess the inter-observer agreement, the inter-observer standard deviation (SD) of the contours was calculated for tumor sites which were identified by all teams.Results: Eighteen of 89 lesions were identified by all teams, all were dominant lesions. The median histological volume of these was 2.4 cm(3). The median inter-observer SD of the delineations was 0.23 cm. Sixty-six of 69 satellites were missed by all teams.Conclusion: Since all teams identify most dominant lesions, dose escalation to the dominant lesion is feasible. Sufficient dose to the whole prostate may need to be maintained to prevent under treatment of smaller lesions and undetected parts of larger lesions. (C) 2015 The Authors. Published by Elsevier Ireland Ltd.

AB - Background and purpose: Boosting the dose to the largest (dominant) lesion in radiotherapy of prostate cancer may improve treatment outcome. The success of this approach relies on the detection and delineation of tumors. The agreement among teams of radiation oncologists and radiologists delineating lesions on multiparametric magnetic resonance imaging (mp-MRI) was assessed by measuring the distances between observer contours. The accuracy of detection and delineation was determined using whole-mount histopathology specimens as reference.Material and methods: Six observer teams delineated tumors on mp-MRI of 20 prostate cancer patients who underwent a prostatectomy. To assess the inter-observer agreement, the inter-observer standard deviation (SD) of the contours was calculated for tumor sites which were identified by all teams.Results: Eighteen of 89 lesions were identified by all teams, all were dominant lesions. The median histological volume of these was 2.4 cm(3). The median inter-observer SD of the delineations was 0.23 cm. Sixty-six of 69 satellites were missed by all teams.Conclusion: Since all teams identify most dominant lesions, dose escalation to the dominant lesion is feasible. Sufficient dose to the whole prostate may need to be maintained to prevent under treatment of smaller lesions and undetected parts of larger lesions. (C) 2015 The Authors. Published by Elsevier Ireland Ltd.

KW - Prostate cancer

KW - Radiotherapy

KW - Tumor delineation

KW - Multiparametric MRI

KW - Dose escalation

KW - Inter-observer variability

KW - WHOLE-MOUNT HISTOPATHOLOGY

KW - SIMULTANEOUS INTEGRATED BOOST

KW - CANCER

KW - MRI

KW - THERAPY

KW - RADIOTHERAPY

KW - METAANALYSIS

KW - PARAMETERS

KW - LESIONS

U2 - 10.1016/j.radonc.2015.04.012

DO - 10.1016/j.radonc.2015.04.012

M3 - Article

SN - 0167-8140

VL - 115

SP - 186

EP - 190

JO - Radiotherapy & Oncology

JF - Radiotherapy & Oncology

IS - 2

ER -

Prostate tumor delineation using multiparametric magnetic resonance imaging: Inter-observer variability and pathology validation

Abstract

Keywords

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