Method of computing direction-dependent margins for the development of consensus contouring guidelines

Radiation Oncology

Liam S. P. Lawrence¹  Angus Z. Lau²  Lee C. L. Chin³  Timothy K. Nguyen⁴  Arjun Sahgal⁵  Chia-Lin Tseng⁵  Rachel W. Chan⁶ 

[1] Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada;Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada;Physical Sciences Platform, Sunnybrook Research Institute, 2075 Bayview Ave., M4N 3M5, Toronto, ON, Canada;Department of Medical Physics, Odette Cancer Centre, Toronto, ON, Canada;Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada;Department of Radiation Oncology, London Health Sciences Centre, Western University, London, ON, Canada;Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada;Physical Sciences Platform, Sunnybrook Research Institute, 2075 Bayview Ave., M4N 3M5, Toronto, ON, Canada;

关键词: Consensus contouring;    Clinical target volume margins;    Interobserver variability;    Stereotactic body radiotherapy;   

DOI  :  10.1186/s13014-021-01799-1

来源: Springer

【 摘 要 】

BackgroundClinical target volume (CTV) contouring guidelines are frequently developed through studies in which experts contour the CTV for a representative set of cases for a given treatment site and the consensus CTVs are analyzed to generate margin recommendations. Measures of interobserver variability are used to quantify agreement between experts. In cases where an isotropic margin is not appropriate, however, there is no standard method to compute margins in specified directions that represent possible routes of tumor spread. Moreover, interobserver variability metrics are often measures of volume overlap that do not account for the dependence of disagreement on direction. To aid in the development of consensus contouring guidelines, this study demonstrates a novel method of quantifying CTV margins and interobserver variability in clinician-specified directions.MethodsThe proposed algorithm was applied to 11 cases of non-spine bone metastases to compute the consensus CTV margin in each direction of intraosseous and extraosseous disease. The median over all cases for each route of spread yielded the recommended margins. The disagreement between experts on the CTV margin was quantified by computing the median of the coefficients of variation for intraosseous and extraosseous margins.ResultsThe recommended intraosseous and extraosseous margins were 7.0 mm and 8.0 mm, respectively. The median coefficient of variation quantifying the margin disagreement between experts was 0.59 and 0.48 for intraosseous and extraosseous disease.ConclusionsThe proposed algorithm permits the generation of margin recommendations in relation to adjacent anatomy and quantifies interobserver variability in specified directions. This method can be applied to future consensus CTV contouring studies.

【 授权许可】

CC BY