Evaluation of variability in target volume delineation for newly diagnosed glioblastoma: a multi-institutional study from the Korean Radiation Oncology Group

Radiation Oncology

Il Han Kim^1,10  Sang Min Yoon^1,16  Chang-Ok Suh⁴  Hye Li Park⁶  Do Hoon Lim⁸  Me Yeon Lee^1,13  Dong Soo Lee^1,17  Suzy Kim⁹  Sung Hwan Kim^1,15  Jin Hee Kim^1,12  In Ah Kim¹  Haeyoung Kim⁷  Jae-Uk Jeong³  Bae-Kwon Jeong^1,18  Tae Jin Han⁵  Kwan Ho Cho²  Hyun-Cheol Kang^1,14  Wonmo Sung^1,19  Chan Woo Wee^1,11 

[1] Seoul National University Bundang Hospital, Gyeonggi-do, Korea;Research Institute and Hospital, National Cancer Center, Gyeonggi-do, Korea;Chonnam National University Hwasun Hospital, Jeollanam-do, Korea;Yonsei University College of Medicine, Seoul, Korea;Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea;Jeonju Jesus Hospital, Jeollabuk-do, Korea;Hallym University Dongtan Sacred Heart Hospital, Gyeonggi-do, Korea;Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea;Seoul National University Boramae Medical Center, Seoul, Korea;Cancer Research Institute; Institute of Radiation Medicine, Seoul National University College of Medicine, 101 Daehak-ro Jongno-gu, Seoul 110-744, Korea;Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea;Keimyung University Dongsan Medical Center, Daegu, Korea;Hallym University Sacred Heart Hospital, Gyeonggi-do, Korea;Dongnam Institute of Radiological and Medical Sciences, Busan, Korea;St. Vincent’s Hospital, The Catholic University of Korea College of Medicine, Gyeonggi-do, Korea;Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea;Uijeongbu St. Mary’s Hospital, The Catholic University of Korea College of Medicine, Gyeonggi-do, Korea;Gyeongsang National University Hospital, Gyeongsangnam-do, Korea;Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea

关键词: Margin;    STAPLE;    Peritumoral edema;    Target volume;    Glioblastoma;   

Others  :  1228508
DOI  :  10.1186/s13014-015-0439-z

 received in 2015-03-19, accepted in 2015-06-16,  发布年份 2015

【 摘 要 】

Background

This study aimed for a collaborative evaluation of variability in the target volumes for glioblastoma, determined and contoured by different radiotherapy (RT) facilities in Korea.

Methods

Fifteen panels of radiation oncologists from independent institutions contoured the gross target volumes (GTVs) and clinical target volumes (CTVs) for 3-dimensional conformal RT or intensity-modulated RT on each simulation CT images, after scrutinizing the enhanced T1-weighted and T2-weighted-fluid-attenuated inversion recovery MR images of 9 different cases of glioblastoma. Degrees of contouring agreement were analyzed by the kappa statistics. Using the algorithm of simultaneous truth and performance level estimation (STAPLE), GTV _STAPLEand CTV _STAPLEcontours were derived.

Results

Contour agreement was moderate (mean kappa 0.58) among the GTVs and was substantial (mean kappa 0.65) among the CTVs. However, each panels’ GTVs and modification of CTVs regarding anatomical structures varied. Three-fourth of contoured panels’ CTVs encompassed the peritumoral areas of T2-high signal intensity (T2-HSI). Nine of nine GTV _STAPLEencompased the surgical cavity and the T1-enhanced lesions. Eight of nine CTV _STAPLEencompassed the peritumoral T2-HSI area. The median MARGIN ₉₀and the median MARGIN ₉₅were 1.4 cm and 1.5 cm, respectively.

Conclusions

Moderate to substantial agreement existed in target volumes for 3-dimensional or intensity-modulated RT determined by radiation oncologists in Korea. According to the estimated consensus contours, the initial CTV encompassed the GTV with margin less than 2.0 cm and the whole peritumoral areas of T2-HSI. The findings of our study propose the need for further studies and modified guidelines.

【 授权许可】

   
2015 Wee et al.

【 图 表 】

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