TY - JOUR
T1 - Target volume delineation variation in radiotherapy for early stage rectal cancer in the Netherlands
AU - Nijkamp, Jasper
AU - de Haas-Kock, Danielle F M
AU - Beukema, Jannet C
AU - Neelis, Karen J
AU - Woutersen, Dankert
AU - Ceha, Heleen
AU - Rozema, Tom
AU - Slot, Annerie
AU - Vos-Westerman, Hanneke
AU - Intven, Martijn
AU - Spruit, Patty H
AU - van der Linden, Yvette
AU - Geijsen, Debby
AU - Verschueren, Karijn
AU - van Herk, Marcel B
AU - Marijnen, Corrie A M
N1 - Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
PY - 2012/1
Y1 - 2012/1
N2 - PURPOSE: The aim of this study was to measure and improve the quality of target volume delineation by means of national consensus on target volume definition in early-stage rectal cancer.METHODS AND MATERIALS: The CTV's for eight patients were delineated by 11 radiation oncologists in 10 institutes according to local guidelines (phase 1). After observer variation analysis a workshop was organized to establish delineation guidelines and a digital atlas, with which the same observers re-delineated the dataset (phase 2). Variation in volume, most caudal and cranial slice and local surface distance variation were analyzed.RESULTS: The average delineated CTV volume decreased from 620 to 460 cc (p<0.001) in phase 2. Variation in the caudal CTV border was reduced significantly from 1.8 to 1.2 cm SD (p=0.01), while it remained 0.7 cm SD for the cranial border. The local surface distance variation (cm SD) reduced from 1.02 to 0.74 for anterior, 0.63 to 0.54 for lateral, 0.33 to 0.25 for posterior and 1.22 to 0.46 for the sphincter region, respectively.CONCLUSIONS: The large variation in target volume delineation could significantly be reduced by use of consensus guidelines and a digital delineation atlas. Despite the significant reduction there is still a need for further improvement.
AB - PURPOSE: The aim of this study was to measure and improve the quality of target volume delineation by means of national consensus on target volume definition in early-stage rectal cancer.METHODS AND MATERIALS: The CTV's for eight patients were delineated by 11 radiation oncologists in 10 institutes according to local guidelines (phase 1). After observer variation analysis a workshop was organized to establish delineation guidelines and a digital atlas, with which the same observers re-delineated the dataset (phase 2). Variation in volume, most caudal and cranial slice and local surface distance variation were analyzed.RESULTS: The average delineated CTV volume decreased from 620 to 460 cc (p<0.001) in phase 2. Variation in the caudal CTV border was reduced significantly from 1.8 to 1.2 cm SD (p=0.01), while it remained 0.7 cm SD for the cranial border. The local surface distance variation (cm SD) reduced from 1.02 to 0.74 for anterior, 0.63 to 0.54 for lateral, 0.33 to 0.25 for posterior and 1.22 to 0.46 for the sphincter region, respectively.CONCLUSIONS: The large variation in target volume delineation could significantly be reduced by use of consensus guidelines and a digital delineation atlas. Despite the significant reduction there is still a need for further improvement.
KW - Atlases as Topic
KW - Female
KW - Humans
KW - Magnetic Resonance Imaging
KW - Male
KW - Netherlands
KW - Patient Positioning
KW - Practice Guidelines as Topic
KW - Quality Assurance, Health Care
KW - Radiation Oncology/standards
KW - Rectal Neoplasms/radiotherapy
KW - Reproducibility of Results
KW - Retrospective Studies
KW - Tomography, X-Ray Computed
U2 - 10.1016/j.radonc.2011.08.011
DO - 10.1016/j.radonc.2011.08.011
M3 - Article
C2 - 21903287
SN - 0167-8140
VL - 102
SP - 14
EP - 21
JO - Radiotherapy & Oncology
JF - Radiotherapy & Oncology
IS - 1
ER -