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Reliability and accuracy assessment of radiation therapy oncology group-endorsed guidelines for brachial plexus contouring

Abstract

The goal of this work was to validate the Radiation Therapy Oncology Group (RTOG)-endorsed guidelines for brachial plexus (BP) contouring by determining the intra- and interobserver agreement. Accuracy of the delineation process was determined using anatomically validated imaging datasets as a gold standard. Five observers delineated the right BP on three cadaver computed tomography (CT) datasets. To assess intraobserver variation, every observer repeated each delineation three times with a time interval of 2 weeks. The BP contours were divided into four regions for detailed analysis. Inter- and intraobserver variation was verified using the Computerized Environment for Radiation Research (CERR) software. Accuracy was measured using anatomically validated fused CT-magnetic resonance imaging (MRI) datasets by measuring the BP inclusion of the delineations. The overall kappa (κ) values were rather low (mean interobserver overall κ: 0.29, mean intraobserver overall κ: 0.45), indicating poor inter- and intraobserver reliability. In general, the κ coefficient decreased gradually from the medial to lateral BP regions. The total agreement volume (TAV) was much smaller than the union volume (UV) for all delineations, resulting in a low Jaccard index (JI; interobserver agreement 0-0.124; intraobserver agreement 0.004-0.636). The overall accuracy was poor, with an average total BP inclusion of 38  More>>
Authors:
Velde, Joris van de; [1]  Ghent University, Department of Radiotherapy, Ghent (Belgium)]; Vercauteren, Tom; Gersem, Werner de; Vandecasteele, Katrien; Vuye, Philippe; Vanpachtenbeke, Frank; Neve, Wilfried de; [2]  Wouters, Johan; Herde, Katharina d'; Kerckaert, Ingrid; Hoof, Tom van [1] 
  1. Ghent University, Department of Anatomy, Ghent (Belgium)
  2. Ghent University, Department of Radiotherapy, Ghent (Belgium)
Publication Date:
Jul 15, 2014
Product Type:
Journal Article
Resource Relation:
Journal Name: Strahlentherapie und Onkologie; Journal Volume: 190; Journal Issue: 7
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ACCURACY; AUTOPSY; CARCINOMAS; COMPUTERIZED TOMOGRAPHY; HEAD; LUNGS; NECK; NERVOUS SYSTEM; NMR IMAGING; PATHOLOGY; RADIATION DOSES; RADIOTHERAPY; RECOMMENDATIONS; RELIABILITY; VALIDATION
OSTI ID:
22266880
Country of Origin:
Germany
Language:
English
Other Identifying Numbers:
Journal ID: ISSN 0179-7158; CODEN: STONE4; TRN: DE14F4068088111
Availability:
Available from: http://dx.doi.org/10.1007/s00066-014-0657-6
Submitting Site:
DE
Size:
page(s) 628-635
Announcement Date:
Oct 04, 2014

Citation Formats

Velde, Joris van de, Ghent University, Department of Radiotherapy, Ghent (Belgium)], Vercauteren, Tom, Gersem, Werner de, Vandecasteele, Katrien, Vuye, Philippe, Vanpachtenbeke, Frank, Neve, Wilfried de, Wouters, Johan, Herde, Katharina d', Kerckaert, Ingrid, and Hoof, Tom van. Reliability and accuracy assessment of radiation therapy oncology group-endorsed guidelines for brachial plexus contouring. Germany: N. p., 2014. Web. doi:10.1007/S00066-014-0657-6.
Velde, Joris van de, Ghent University, Department of Radiotherapy, Ghent (Belgium)], Vercauteren, Tom, Gersem, Werner de, Vandecasteele, Katrien, Vuye, Philippe, Vanpachtenbeke, Frank, Neve, Wilfried de, Wouters, Johan, Herde, Katharina d', Kerckaert, Ingrid, & Hoof, Tom van. Reliability and accuracy assessment of radiation therapy oncology group-endorsed guidelines for brachial plexus contouring. Germany. doi:10.1007/S00066-014-0657-6.
Velde, Joris van de, Ghent University, Department of Radiotherapy, Ghent (Belgium)], Vercauteren, Tom, Gersem, Werner de, Vandecasteele, Katrien, Vuye, Philippe, Vanpachtenbeke, Frank, Neve, Wilfried de, Wouters, Johan, Herde, Katharina d', Kerckaert, Ingrid, and Hoof, Tom van. 2014. "Reliability and accuracy assessment of radiation therapy oncology group-endorsed guidelines for brachial plexus contouring." Germany. doi:10.1007/S00066-014-0657-6. https://www.osti.gov/servlets/purl/10.1007/S00066-014-0657-6.
@misc{etde_22266880,
title = {Reliability and accuracy assessment of radiation therapy oncology group-endorsed guidelines for brachial plexus contouring}
author = {Velde, Joris van de, Ghent University, Department of Radiotherapy, Ghent (Belgium)], Vercauteren, Tom, Gersem, Werner de, Vandecasteele, Katrien, Vuye, Philippe, Vanpachtenbeke, Frank, Neve, Wilfried de, Wouters, Johan, Herde, Katharina d', Kerckaert, Ingrid, and Hoof, Tom van}
abstractNote = {The goal of this work was to validate the Radiation Therapy Oncology Group (RTOG)-endorsed guidelines for brachial plexus (BP) contouring by determining the intra- and interobserver agreement. Accuracy of the delineation process was determined using anatomically validated imaging datasets as a gold standard. Five observers delineated the right BP on three cadaver computed tomography (CT) datasets. To assess intraobserver variation, every observer repeated each delineation three times with a time interval of 2 weeks. The BP contours were divided into four regions for detailed analysis. Inter- and intraobserver variation was verified using the Computerized Environment for Radiation Research (CERR) software. Accuracy was measured using anatomically validated fused CT-magnetic resonance imaging (MRI) datasets by measuring the BP inclusion of the delineations. The overall kappa (κ) values were rather low (mean interobserver overall κ: 0.29, mean intraobserver overall κ: 0.45), indicating poor inter- and intraobserver reliability. In general, the κ coefficient decreased gradually from the medial to lateral BP regions. The total agreement volume (TAV) was much smaller than the union volume (UV) for all delineations, resulting in a low Jaccard index (JI; interobserver agreement 0-0.124; intraobserver agreement 0.004-0.636). The overall accuracy was poor, with an average total BP inclusion of 38 %. Inclusions were insufficient for the most lateral regions (region 3: 21.5 %; region 4: 12.6 %). The inter- and intraobserver reliability of the RTOG-endorsed BP contouring guidelines was poor. BP inclusion worsened from the medial to lateral regions. Accuracy assessment of the contours showed an average BP inclusion of 38 %. For the first time, this was assessed using the original anatomically validated BP volume. The RTOG-endorsed BP guidelines have insufficient accuracy and reliability, especially for the lateral head-and-neck regions. (orig.) [German] Ziel der Studie war es, die von der ''Radiation Therapy Oncology Group'' (RTOG) unterstuetzten Richtlinien fuer die Plexus-brachialis-(PB-)Konturierung durch Bestimmung von Inter- und Intraobserver-Reliabilitaet zu validieren. Die Praezision des Abgrenzungsprozesses wurde unter Verwendung anatomisch validierter Bilddatensaetze als Goldstandard bestimmt. Fuenf Beobachter skizzierten im Tomographiedatensatz von drei Leichen den rechten PB. Um die Intraobserver-Abweichung zu bestimmen, wiederholte jeder Beobachter jede Konturierung 3-mal mit einem Zeitintervall von 2 Wochen. Die PB-Konturierungen wurden zur Detailanalyse in 4 Bereiche eingeteilt. Die Inter- und Intraobserver-Abweichungen wurden mit Hilfe der ''Computerized-Environment-Radiation-Research''-(CERR-)Software geprueft. Die Praezision wurde anhand anatomisch validierter CT-MRI-Datensaetze durch Messung der PB-Inklusion der Konturierung bestimmt. Die gesamten κ-Werte waren eher niedrig (durchschnittliches Gesamt-Interobserver-κ: 0,29; durchschnittliches Gesamt-Intraobserver-κ: 0,45), was auf eine schwache Inter- und Intraobserver-Zuverlaessigkeit hinweist. Im Allgemeinen nahm der κ-Koeffizient vom medialen zum seitlichen Bereich schrittweise ab. Das ''Total Agreement Volume'' (TAV) war fuer alle konturierungen viel kleiner als das ''Union Volume'' (UV), was einen niedrigen Jaccard-Index (JI) ergab (Interobserver-Uebereinstimmung 0-0,124; Intraobserver-Uebereinstimmung 0,004-0,636). Die gesamte Praezision war schwach, mit einem gesamten durchschnittlichen PB-Einschluss von 38 %. Die Inklusionen waren unzureichend fuer die meisten seitlichen Bereiche (Bereich 3: 21,5 %; Bereich 4: 12,6 %). Die Inter- und Intraobserver-Reliabilitaet der von der RTOG unterstuetzten Richtlinien fuer die PB-Konturierung waren schwach. Die PB-Inklusion liess vom mittleren zum seitlichen Bereich nach. Die Bestimmung der Praezision der Konturierung zeigte eine durchschnittliche PB-Inklusion von 38 %. Zum ersten Mal wurde dies anhand des urspruenglichen, anatomisch validierten PB-Volumens bestimmt. Die RTOG-unterstuetzten PB-Richtlinien zeigen eine unzureichende Praezision und Zuverlaessigkeit, vor allem fuer den seitlichen Kopf-Hals-Bereich. (orig.)}
doi = {10.1007/S00066-014-0657-6}
journal = {Strahlentherapie und Onkologie}
issue = {7}
volume = {190}
journal type = {AC}
place = {Germany}
year = {2014}
month = {Jul}
}