Document Detail


Interobserver variation in clinical target volume and organs at risk segmentation in post-parotidectomy radiotherapy: can segmentation protocols help?
MedLine Citation:
PMID:  22815423     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: A study of interobserver variation in the segmentation of the post-operative clinical target volume (CTV) and organs at risk (OARs) for parotid tumours was undertaken. The segmentation exercise was performed as a baseline, and repeated after 3 months using a segmentation protocol to assess whether CTV conformity improved.
METHODS: Four head and neck oncologists independently segmented CTVs and OARs (contralateral parotid, spinal cord and brain stem) on CT data sets of five patients post parotidectomy. For each CTV or OAR delineation, total volume was calculated. The conformity level (CL) between different clinicians' outlines was measured using a validated outline analysis tool. The data for CTVs were re-analysed after using the cochlear sparing therapy and conventional radiation segmentation protocol.
RESULTS: Significant differences in CTV morphology were observed at baseline, yielding a mean CL of 30% (range 25-39%). The CL improved after using the segmentation protocol with a mean CL of 54% (range 50-65%). For OARs, the mean CL was 60% (range 53-68%) for the contralateral parotid gland, 23% (range 13-27%) for the brain stem and 25% (range 22-31%) for the spinal cord.
CONCLUSIONS: There was low conformity for CTVs and OARs between different clinicians. The CL for CTVs improved with use of a segmentation protocol, but the CLs remained lower than expected. This study supports the need for clear guidelines for segmentation of target and OARs to compare and interpret the results of head and neck cancer radiation studies.
Authors:
M Mukesh; R Benson; R Jena; A Hoole; T Roques; C Scrase; C Martin; G A Whitfield; J Gemmill; S Jefferies
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The British journal of radiology     Volume:  85     ISSN:  1748-880X     ISO Abbreviation:  Br J Radiol     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-07-20     Completed Date:  2012-10-01     Revised Date:  2013-08-12    
Medline Journal Info:
Nlm Unique ID:  0373125     Medline TA:  Br J Radiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  e530-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Oncology, Addenbrooke's Hospital, Cambridge, UK. drmukesh12@doctors.net.uk
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MeSH Terms
Descriptor/Qualifier:
Brain Stem / radiation effects,  radiography
Humans
Observer Variation
Organ Size
Organs at Risk / radiography*
Parotid Gland / radiation effects,  radiography,  surgery
Parotid Neoplasms / radiography,  radiotherapy,  surgery*
Practice Guidelines as Topic
Radiation Oncology / standards
Radiotherapy, Intensity-Modulated / methods
Spinal Cord / radiation effects,  radiography
Tomography, X-Ray Computed
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