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Title: Toward Semi-automated Assessment of Target Volume Delineation in Radiotherapy Trials: The SCOPE 1 Pretrial Test Case

Abstract

Purpose: To evaluate different conformity indices (CIs) for use in the analysis of outlining consistency within the pretrial quality assurance (Radiotherapy Trials Quality Assurance [RTTQA]) program of a multicenter chemoradiation trial of esophageal cancer and to make recommendations for their use in future trials. Methods and Materials: The National Cancer Research Institute SCOPE 1 trial is an ongoing Cancer Research UK-funded phase II/III randomized controlled trial of chemoradiation with capecitabine and cisplatin with or without cetuximab for esophageal cancer. The pretrial RTTQA program included a detailed radiotherapy protocol, an educational package, and a single mid-esophageal tumor test case that were sent to each investigator to outline. Investigator gross tumor volumes (GTVs) were received from 50 investigators in 34 UK centers, and CERR (Computational Environment for Radiotherapy Research) was used to perform an assessment of each investigator GTV against a predefined gold-standard GTV using different CIs. A new metric, the local conformity index (l-CI), that can localize areas of maximal discordance was developed. Results: The median Jaccard conformity index (JCI) was 0.69 (interquartile range, 0.62-0.70), with 14 of 50 investigators (28%) achieving a JCI of 0.7 or greater. The median geographical miss index was 0.09 (interquartile range, 0.06-0.16), and the meanmore » discordance index was 0.27 (95% confidence interval, 0.25-0.30). The l-CI was highest in the middle section of the volume, where the tumor was bulky and more easily definable, and identified 4 slices where fewer than 20% of investigators achieved an l-CI of 0.7 or greater. Conclusions: The available CIs analyze different aspects of a gold standard-observer variation, with JCI being the most useful as a single metric. Additional information is provided by the l-CI and can focus the efforts of the RTTQA team in these areas, possibly leading to semi-automated outlining assessment.« less

Authors:
 [1]; ;  [2]; ;  [3];  [4];  [1];  [3];  [1];  [5]
  1. Department of Clinical Oncology, Velindre Cancer Centre, Cardiff, Wales (United Kingdom)
  2. Department of Medical Physics, Velindre Cancer Centre, Cardiff, Wales (United Kingdom)
  3. Wales Cancer Trials Unit, School of Medicine, Cardiff University, Cardiff, Wales (United Kingdom)
  4. Department of Diagnostic Radiology, Velindre Cancer Centre, Cardiff, Wales (United Kingdom)
  5. Division of Cancer, School of Medicine, Cardiff University, Cardiff, Wales (United Kingdom)
Publication Date:
OSTI Identifier:
22149653
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 84; Journal Issue: 4; Other Information: Copyright (c) 2012 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ESOPHAGUS; METRICS; NEOPLASMS; QUALITY ASSURANCE; RADIOTHERAPY; RECOMMENDATIONS; STANDARDS

Citation Formats

Gwynne, Sarah, E-mail: Sarah.Gwynne2@wales.nhs.uk, Spezi, Emiliano, Wills, Lucy, Nixon, Lisette, Hurt, Chris, Joseph, George, Evans, Mererid, Griffiths, Gareth, Crosby, Tom, and Staffurth, John. Toward Semi-automated Assessment of Target Volume Delineation in Radiotherapy Trials: The SCOPE 1 Pretrial Test Case. United States: N. p., 2012. Web. doi:10.1016/J.IJROBP.2012.01.094.
Gwynne, Sarah, E-mail: Sarah.Gwynne2@wales.nhs.uk, Spezi, Emiliano, Wills, Lucy, Nixon, Lisette, Hurt, Chris, Joseph, George, Evans, Mererid, Griffiths, Gareth, Crosby, Tom, & Staffurth, John. Toward Semi-automated Assessment of Target Volume Delineation in Radiotherapy Trials: The SCOPE 1 Pretrial Test Case. United States. doi:10.1016/J.IJROBP.2012.01.094.
Gwynne, Sarah, E-mail: Sarah.Gwynne2@wales.nhs.uk, Spezi, Emiliano, Wills, Lucy, Nixon, Lisette, Hurt, Chris, Joseph, George, Evans, Mererid, Griffiths, Gareth, Crosby, Tom, and Staffurth, John. Thu . "Toward Semi-automated Assessment of Target Volume Delineation in Radiotherapy Trials: The SCOPE 1 Pretrial Test Case". United States. doi:10.1016/J.IJROBP.2012.01.094.
@article{osti_22149653,
title = {Toward Semi-automated Assessment of Target Volume Delineation in Radiotherapy Trials: The SCOPE 1 Pretrial Test Case},
author = {Gwynne, Sarah, E-mail: Sarah.Gwynne2@wales.nhs.uk and Spezi, Emiliano and Wills, Lucy and Nixon, Lisette and Hurt, Chris and Joseph, George and Evans, Mererid and Griffiths, Gareth and Crosby, Tom and Staffurth, John},
abstractNote = {Purpose: To evaluate different conformity indices (CIs) for use in the analysis of outlining consistency within the pretrial quality assurance (Radiotherapy Trials Quality Assurance [RTTQA]) program of a multicenter chemoradiation trial of esophageal cancer and to make recommendations for their use in future trials. Methods and Materials: The National Cancer Research Institute SCOPE 1 trial is an ongoing Cancer Research UK-funded phase II/III randomized controlled trial of chemoradiation with capecitabine and cisplatin with or without cetuximab for esophageal cancer. The pretrial RTTQA program included a detailed radiotherapy protocol, an educational package, and a single mid-esophageal tumor test case that were sent to each investigator to outline. Investigator gross tumor volumes (GTVs) were received from 50 investigators in 34 UK centers, and CERR (Computational Environment for Radiotherapy Research) was used to perform an assessment of each investigator GTV against a predefined gold-standard GTV using different CIs. A new metric, the local conformity index (l-CI), that can localize areas of maximal discordance was developed. Results: The median Jaccard conformity index (JCI) was 0.69 (interquartile range, 0.62-0.70), with 14 of 50 investigators (28%) achieving a JCI of 0.7 or greater. The median geographical miss index was 0.09 (interquartile range, 0.06-0.16), and the mean discordance index was 0.27 (95% confidence interval, 0.25-0.30). The l-CI was highest in the middle section of the volume, where the tumor was bulky and more easily definable, and identified 4 slices where fewer than 20% of investigators achieved an l-CI of 0.7 or greater. Conclusions: The available CIs analyze different aspects of a gold standard-observer variation, with JCI being the most useful as a single metric. Additional information is provided by the l-CI and can focus the efforts of the RTTQA team in these areas, possibly leading to semi-automated outlining assessment.},
doi = {10.1016/J.IJROBP.2012.01.094},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 4,
volume = 84,
place = {United States},
year = {2012},
month = {11}
}