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Published in: Journal of Digital Imaging 1/2014

01-02-2014

Development of a Software for Quantitative Evaluation Radiotherapy Target and Organ-at-Risk Segmentation Comparison

Authors: Jayashree Kalpathy-Cramer, Musaddiq Awan, Steven Bedrick, Coen R. N. Rasch, David I. Rosenthal, Clifton D. Fuller

Published in: Journal of Imaging Informatics in Medicine | Issue 1/2014

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Abstract

Modern radiotherapy requires accurate region of interest (ROI) inputs for plan optimization and delivery. Target delineation, however, remains operator-dependent and potentially serves as a major source of treatment delivery error. In order to optimize this critical, yet observer-driven process, a flexible web-based platform for individual and cooperative target delineation analysis and instruction was developed in order to meet the following unmet needs: (1) an open-source/open-access platform for automated/semiautomated quantitative interobserver and intraobserver ROI analysis and comparison, (2) a real-time interface for radiation oncology trainee online self-education in ROI definition, and (3) a source for pilot data to develop and validate quality metrics for institutional and cooperative group quality assurance efforts. The resultant software, Target Contour Testing/Instructional Computer Software (TaCTICS), developed using Ruby on Rails, has since been implemented and proven flexible, feasible, and useful in several distinct analytical and research applications.
Literature
1.
go back to reference Report 83: prescribing, recording, and reporting photon-beam intensity-modulated radiation therapy (IMRT). J ICRU 10:1–106, 2010 Report 83: prescribing, recording, and reporting photon-beam intensity-modulated radiation therapy (IMRT). J ICRU 10:1–106, 2010
2.
go back to reference Rosenthal DI, Chambers MS, Fuller CD, et al: Beam path toxicities to non-target structures during intensity-modulated radiation therapy for head and neck cancer. Int J Radiat Oncol Biol Phys 72:747–755, 2008PubMedCrossRef Rosenthal DI, Chambers MS, Fuller CD, et al: Beam path toxicities to non-target structures during intensity-modulated radiation therapy for head and neck cancer. Int J Radiat Oncol Biol Phys 72:747–755, 2008PubMedCrossRef
3.
go back to reference Garden AS, Lewin JS, Chambers MS: How to reduce radiation-related toxicity in patients with cancer of the head and neck. Curr Oncol Rep 8:140–145, 2006PubMedCrossRef Garden AS, Lewin JS, Chambers MS: How to reduce radiation-related toxicity in patients with cancer of the head and neck. Curr Oncol Rep 8:140–145, 2006PubMedCrossRef
4.
go back to reference Rosenthal DI, Blanco AI: Head and neck squamous cell carcinoma: optimizing the therapeutic index. Expert Rev Anticancer Ther 5:501–514, 2005PubMedCrossRef Rosenthal DI, Blanco AI: Head and neck squamous cell carcinoma: optimizing the therapeutic index. Expert Rev Anticancer Ther 5:501–514, 2005PubMedCrossRef
5.
go back to reference Van Kampen M, Levegrun S, Wannenmacher M: Target volume definition in radiation therapy. Br J Radiol 70(Spec No):S25–S31, 1997PubMed Van Kampen M, Levegrun S, Wannenmacher M: Target volume definition in radiation therapy. Br J Radiol 70(Spec No):S25–S31, 1997PubMed
7.
go back to reference Lichter AS, Ten Haken RK: Three-dimensional treatment planning and conformal radiation dose delivery. Important Adv Oncol 1995:95–109, 1995 Lichter AS, Ten Haken RK: Three-dimensional treatment planning and conformal radiation dose delivery. Important Adv Oncol 1995:95–109, 1995
10.
go back to reference Smith RP, Heron DE, Huq MS, et al: Modern radiation treatment planning and delivery—from Rontgen to real time. Hematol Oncol Clin N Am 20:45–62, 2006CrossRef Smith RP, Heron DE, Huq MS, et al: Modern radiation treatment planning and delivery—from Rontgen to real time. Hematol Oncol Clin N Am 20:45–62, 2006CrossRef
11.
go back to reference Gregoire V, Jeraj R, Lee JA, et al: Radiotherapy for head and neck tumours in 2012 and beyond: conformal, tailored, and adaptive? Lancet Oncol 13:e292–e300, 2012PubMedCrossRef Gregoire V, Jeraj R, Lee JA, et al: Radiotherapy for head and neck tumours in 2012 and beyond: conformal, tailored, and adaptive? Lancet Oncol 13:e292–e300, 2012PubMedCrossRef
12.
go back to reference Schwartz DL, Garden AS, Thomas J, et al: Adaptive radiotherapy for head-and-neck cancer: initial clinical outcomes from a prospective trial. Int J Radiat Oncol Biol Phys 83:986–993, 2012PubMedCrossRef Schwartz DL, Garden AS, Thomas J, et al: Adaptive radiotherapy for head-and-neck cancer: initial clinical outcomes from a prospective trial. Int J Radiat Oncol Biol Phys 83:986–993, 2012PubMedCrossRef
14.
go back to reference Multi-Institutional Target Delineation in Oncology Group: Human–computer interaction in radiotherapy target volume delineation: a prospective, multi-institutional comparison of user input devices. J Digit Imaging 24:794–803, 2011 Multi-Institutional Target Delineation in Oncology Group: Human–computer interaction in radiotherapy target volume delineation: a prospective, multi-institutional comparison of user input devices. J Digit Imaging 24:794–803, 2011
15.
go back to reference Njeh CF: Tumor delineation: the weakest link in the search for accuracy in radiotherapy. J Med Phys Assoc Med Physicists India 33:136–140, 2008 Njeh CF: Tumor delineation: the weakest link in the search for accuracy in radiotherapy. J Med Phys Assoc Med Physicists India 33:136–140, 2008
16.
go back to reference Fuller CD, Nijkamp J, Duppen JC, et al: Prospective randomized double-blind pilot study of site-specific consensus atlas implementation for rectal cancer target volume delineation in the cooperative group setting. Int J Radiat Oncol Biol Phys 79:481–489, 2011PubMedCentralPubMedCrossRef Fuller CD, Nijkamp J, Duppen JC, et al: Prospective randomized double-blind pilot study of site-specific consensus atlas implementation for rectal cancer target volume delineation in the cooperative group setting. Int J Radiat Oncol Biol Phys 79:481–489, 2011PubMedCentralPubMedCrossRef
17.
go back to reference Eskander RN, Scanderbeg D, Saenz CC, et al: Comparison of computed tomography and magnetic resonance imaging in cervical cancer brachytherapy target and normal tissue contouring. Int J Gynecol Cancer: Off J Int Gynecol Cancer Soc 20:47–53, 2010CrossRef Eskander RN, Scanderbeg D, Saenz CC, et al: Comparison of computed tomography and magnetic resonance imaging in cervical cancer brachytherapy target and normal tissue contouring. Int J Gynecol Cancer: Off J Int Gynecol Cancer Soc 20:47–53, 2010CrossRef
18.
go back to reference Peters LJ, O’Sullivan B, Giralt J, et al: Critical impact of radiotherapy protocol compliance and quality in the treatment of advanced head and neck cancer: results from TROG 02.02. J Clin Oncol: Off J Am Soc Clin Oncol 28:2996–3001, 2010CrossRef Peters LJ, O’Sullivan B, Giralt J, et al: Critical impact of radiotherapy protocol compliance and quality in the treatment of advanced head and neck cancer: results from TROG 02.02. J Clin Oncol: Off J Am Soc Clin Oncol 28:2996–3001, 2010CrossRef
19.
go back to reference Weber DC, Poortmans PM, Hurkmans CW, et al: Quality assurance for prospective EORTC radiation oncology trials: the challenges of advanced technology in a multicenter international setting. Radiother Oncol: J Eur Soc Ther Radiol Oncol 100:150–156, 2011CrossRef Weber DC, Poortmans PM, Hurkmans CW, et al: Quality assurance for prospective EORTC radiation oncology trials: the challenges of advanced technology in a multicenter international setting. Radiother Oncol: J Eur Soc Ther Radiol Oncol 100:150–156, 2011CrossRef
20.
go back to reference Okunieff P, Kachnic LA, Constine LS, et al: Report from the Radiation Therapy Committee of the Southwest Oncology Group (SWOG): Research Objectives Workshop 2008. Clin Cancer Res: Off J Am Assoc Cancer Res 15:5663–5670, 2009CrossRef Okunieff P, Kachnic LA, Constine LS, et al: Report from the Radiation Therapy Committee of the Southwest Oncology Group (SWOG): Research Objectives Workshop 2008. Clin Cancer Res: Off J Am Assoc Cancer Res 15:5663–5670, 2009CrossRef
21.
go back to reference Bekelman JE, Wolden S, Lee N: Head-and-neck target delineation among radiation oncology residents after a teaching intervention: a prospective, blinded pilot study. Int J Radiat Oncol Biol Phys 73:416–423, 2009PubMedCrossRef Bekelman JE, Wolden S, Lee N: Head-and-neck target delineation among radiation oncology residents after a teaching intervention: a prospective, blinded pilot study. Int J Radiat Oncol Biol Phys 73:416–423, 2009PubMedCrossRef
22.
go back to reference Li XA, Tai A, Arthur DW, et al: Variability of target and normal structure delineation for breast cancer radiotherapy: an RTOG Multi-Institutional and Multiobserver Study. Int J Radiat Oncol Biol Phys 73:944–951, 2009PubMedCentralPubMedCrossRef Li XA, Tai A, Arthur DW, et al: Variability of target and normal structure delineation for breast cancer radiotherapy: an RTOG Multi-Institutional and Multiobserver Study. Int J Radiat Oncol Biol Phys 73:944–951, 2009PubMedCentralPubMedCrossRef
23.
go back to reference Tai P, Van Dyk J, Yu E, et al: Variability of target volume delineation in cervical esophageal cancer. Int J Radiat Oncol Biol Phys 42:277–288, 1998PubMedCrossRef Tai P, Van Dyk J, Yu E, et al: Variability of target volume delineation in cervical esophageal cancer. Int J Radiat Oncol Biol Phys 42:277–288, 1998PubMedCrossRef
24.
go back to reference Goodman KA, Regine WF, Dawson LA, et al: Radiation Therapy Oncology Group consensus panel guidelines for the delineation of the clinical target volume in the postoperative treatment of pancreatic head cancer. Int J Radiat Oncol Biol Phys 83:901–908, 2012PubMedCrossRef Goodman KA, Regine WF, Dawson LA, et al: Radiation Therapy Oncology Group consensus panel guidelines for the delineation of the clinical target volume in the postoperative treatment of pancreatic head cancer. Int J Radiat Oncol Biol Phys 83:901–908, 2012PubMedCrossRef
25.
go back to reference Ng M, Leong T, Chander S, et al: Australasian Gastrointestinal Trials Group (AGITG) contouring atlas and planning guidelines for intensity-modulated radiotherapy in anal cancer. Int J Radiat Oncol Biol Phys 83:1455–1462, 2012PubMedCrossRef Ng M, Leong T, Chander S, et al: Australasian Gastrointestinal Trials Group (AGITG) contouring atlas and planning guidelines for intensity-modulated radiotherapy in anal cancer. Int J Radiat Oncol Biol Phys 83:1455–1462, 2012PubMedCrossRef
26.
go back to reference Nijkamp J, de Haas-Kock DF, Beukema JC, et al: Target volume delineation variation in radiotherapy for early stage rectal cancer in the Netherlands. Radiother Oncol: J Eur Soc Ther Radiol Oncol 102:14–21, 2012CrossRef Nijkamp J, de Haas-Kock DF, Beukema JC, et al: Target volume delineation variation in radiotherapy for early stage rectal cancer in the Netherlands. Radiother Oncol: J Eur Soc Ther Radiol Oncol 102:14–21, 2012CrossRef
27.
go back to reference Vorwerk H, Hess CF: Guidelines for delineation of lymphatic clinical target volumes for high conformal radiotherapy: head and neck region. Radiat Oncol 6:97, 2011PubMedCentralPubMedCrossRef Vorwerk H, Hess CF: Guidelines for delineation of lymphatic clinical target volumes for high conformal radiotherapy: head and neck region. Radiat Oncol 6:97, 2011PubMedCentralPubMedCrossRef
28.
go back to reference Wang D, Bosch W, Roberge D, et al: RTOG sarcoma radiation oncologists reach consensus on gross tumor volume and clinical target volume on computed tomographic images for preoperative radiotherapy of primary soft tissue sarcoma of extremity in Radiation Therapy Oncology Group studies. Int J Radiat Oncol Biol Phys 81:e525–e528, 2011PubMedCentralPubMedCrossRef Wang D, Bosch W, Roberge D, et al: RTOG sarcoma radiation oncologists reach consensus on gross tumor volume and clinical target volume on computed tomographic images for preoperative radiotherapy of primary soft tissue sarcoma of extremity in Radiation Therapy Oncology Group studies. Int J Radiat Oncol Biol Phys 81:e525–e528, 2011PubMedCentralPubMedCrossRef
29.
go back to reference Kong FM, Ritter T, Quint DJ, et al: Consideration of dose limits for organs at risk of thoracic radiotherapy: atlas for lung, proximal bronchial tree, esophagus, spinal cord, ribs, and brachial plexus. Int J Radiat Oncol Biol Phys 81:1442–1457, 2011PubMedCrossRef Kong FM, Ritter T, Quint DJ, et al: Consideration of dose limits for organs at risk of thoracic radiotherapy: atlas for lung, proximal bronchial tree, esophagus, spinal cord, ribs, and brachial plexus. Int J Radiat Oncol Biol Phys 81:1442–1457, 2011PubMedCrossRef
30.
go back to reference Vorwerk H, Beckmann G, Bremer M, et al: The delineation of target volumes for radiotherapy of lung cancer patients. Radiother Oncol: J Eur Soc Ther Radiol Oncol 91:455–460, 2009CrossRef Vorwerk H, Beckmann G, Bremer M, et al: The delineation of target volumes for radiotherapy of lung cancer patients. Radiother Oncol: J Eur Soc Ther Radiol Oncol 91:455–460, 2009CrossRef
31.
go back to reference Weiss E, Richter S, Krauss T, et al: Conformal radiotherapy planning of cervix carcinoma: differences in the delineation of the clinical target volume. A comparison between gynaecologic and radiation oncologists. Radiother Oncol: J Eur Soc Ther Radiol Oncol 67:87–95, 2003CrossRef Weiss E, Richter S, Krauss T, et al: Conformal radiotherapy planning of cervix carcinoma: differences in the delineation of the clinical target volume. A comparison between gynaecologic and radiation oncologists. Radiother Oncol: J Eur Soc Ther Radiol Oncol 67:87–95, 2003CrossRef
32.
go back to reference Allozi R, Li XA, White J, et al: Tools for consensus analysis of experts’ contours for radiotherapy structure definitions. Radiother Oncol: J Eur Soc Ther Radiol Oncol 97:572–578, 2010CrossRef Allozi R, Li XA, White J, et al: Tools for consensus analysis of experts’ contours for radiotherapy structure definitions. Radiother Oncol: J Eur Soc Ther Radiol Oncol 97:572–578, 2010CrossRef
34.
go back to reference Rasch CR, Steenbakkers RJ, Fitton I, et al: Decreased 3D observer variation with matched CT-MRI, for target delineation in nasopharynx cancer. Radiat Oncol 5:21, 2010PubMedCentralPubMedCrossRef Rasch CR, Steenbakkers RJ, Fitton I, et al: Decreased 3D observer variation with matched CT-MRI, for target delineation in nasopharynx cancer. Radiat Oncol 5:21, 2010PubMedCentralPubMedCrossRef
35.
go back to reference Steenbakkers RJ, Duppen JC, Fitton I, et al: Observer variation in target volume delineation of lung cancer related to radiation oncologist–computer interaction: a ‘Big Brother’ evaluation. Radiother: J Eur Soc Ther Radiol Oncol 77:182–190, 2005CrossRef Steenbakkers RJ, Duppen JC, Fitton I, et al: Observer variation in target volume delineation of lung cancer related to radiation oncologist–computer interaction: a ‘Big Brother’ evaluation. Radiother: J Eur Soc Ther Radiol Oncol 77:182–190, 2005CrossRef
36.
go back to reference Steenbakkers RJ, Duppen JC, Fitton I, et al: Reduction of observer variation using matched CT-PET for lung cancer delineation: a three-dimensional analysis. Int J Radiat Oncol Biol Phys 64:435–448, 2006PubMedCrossRef Steenbakkers RJ, Duppen JC, Fitton I, et al: Reduction of observer variation using matched CT-PET for lung cancer delineation: a three-dimensional analysis. Int J Radiat Oncol Biol Phys 64:435–448, 2006PubMedCrossRef
37.
go back to reference Jansen EP, Nijkamp J, Gubanski M, et al: Interobserver variation of clinical target volume delineation in gastric cancer. Int J Radiat Oncol Biol Phys 77:1166–1170, 2010PubMedCrossRef Jansen EP, Nijkamp J, Gubanski M, et al: Interobserver variation of clinical target volume delineation in gastric cancer. Int J Radiat Oncol Biol Phys 77:1166–1170, 2010PubMedCrossRef
38.
go back to reference Roelofs E, Persoon L, Qamhiyeh S, et al: Design of and technical challenges involved in a framework for multicentric radiotherapy treatment planning studies. Radiother Oncol: J Eur Soc Ther Radiol Oncol 97:567–571, 2010CrossRef Roelofs E, Persoon L, Qamhiyeh S, et al: Design of and technical challenges involved in a framework for multicentric radiotherapy treatment planning studies. Radiother Oncol: J Eur Soc Ther Radiol Oncol 97:567–571, 2010CrossRef
41.
go back to reference Dice LR: Measures of the amount of ecologic association between species. Ecology 26:297–302, 1945CrossRef Dice LR: Measures of the amount of ecologic association between species. Ecology 26:297–302, 1945CrossRef
42.
go back to reference Jaccard P: The distribution of the flora in the alpine zone. New Phytol 11:37–50, 1912CrossRef Jaccard P: The distribution of the flora in the alpine zone. New Phytol 11:37–50, 1912CrossRef
43.
go back to reference Crum WR, Camara O, Hill DL: Generalized overlap measures for evaluation and validation in medical image analysis. IEEE Trans Med Imaging 25:1451–1461, 2006PubMedCrossRef Crum WR, Camara O, Hill DL: Generalized overlap measures for evaluation and validation in medical image analysis. IEEE Trans Med Imaging 25:1451–1461, 2006PubMedCrossRef
44.
45.
go back to reference Mitra J, Kato Z, Marti R, et al: A spline-based non-linear diffeomorphism for multimodal prostate registration. Med Image Anal 16:1259–1279, 2012 Mitra J, Kato Z, Marti R, et al: A spline-based non-linear diffeomorphism for multimodal prostate registration. Med Image Anal 16:1259–1279, 2012
46.
go back to reference Mitra J, Marti R, Oliver A, et al: Prostate multimodality image registration based on B-splines and quadrature local energy. Int J CARS 7:445–454, 2012CrossRef Mitra J, Marti R, Oliver A, et al: Prostate multimodality image registration based on B-splines and quadrature local energy. Int J CARS 7:445–454, 2012CrossRef
47.
go back to reference Oguro S, Tuncali K, Elhawary H, et al: Image registration of pre-procedural MRI and intra-procedural CT images to aid CT-guided percutaneous cryoablation of renal tumors. Int J CARS 6:111–117, 2011CrossRef Oguro S, Tuncali K, Elhawary H, et al: Image registration of pre-procedural MRI and intra-procedural CT images to aid CT-guided percutaneous cryoablation of renal tumors. Int J CARS 6:111–117, 2011CrossRef
48.
go back to reference Warfield SK, Zou KH, Wells WM: Simultaneous Truth and Performance Level Estimation (STAPLE): an algorithm for the validation of image segmentation. IEEE Trans Med Imaging 23:903–921, 2004PubMedCentralPubMedCrossRef Warfield SK, Zou KH, Wells WM: Simultaneous Truth and Performance Level Estimation (STAPLE): an algorithm for the validation of image segmentation. IEEE Trans Med Imaging 23:903–921, 2004PubMedCentralPubMedCrossRef
49.
go back to reference Gomez D, Komaki R, Yu J, et al: Radiation therapy definitions and reporting guidelines for thymic malignancies. J Thorac Oncol: Off Publ Int Assoc Study Lung Cancer 6:S1743–S1748, 2011CrossRef Gomez D, Komaki R, Yu J, et al: Radiation therapy definitions and reporting guidelines for thymic malignancies. J Thorac Oncol: Off Publ Int Assoc Study Lung Cancer 6:S1743–S1748, 2011CrossRef
50.
go back to reference Thomas CR, Kalpathy-Cramer J, Senan S, et al: Development of an expert consensus target delineation atlas for thymic cancers: Initial results of an expert survey. International Thymic Malignancy Interest Group, Amsterdam, 2011 Thomas CR, Kalpathy-Cramer J, Senan S, et al: Development of an expert consensus target delineation atlas for thymic cancers: Initial results of an expert survey. International Thymic Malignancy Interest Group, Amsterdam, 2011
51.
go back to reference Bongers EM, Dahele MR, Slotman BJ: Proton stereotactic body radiation therapy for clinically challenging cases of centrally and superiorly located stage I non-small-cell lung cancer: in regards to Register et al. Int J Radiat Oncol Biol Phys 82:492, author reply 492, 2012 Bongers EM, Dahele MR, Slotman BJ: Proton stereotactic body radiation therapy for clinically challenging cases of centrally and superiorly located stage I non-small-cell lung cancer: in regards to Register et al. Int J Radiat Oncol Biol Phys 82:492, author reply 492, 2012
52.
go back to reference Kalpathy-Cramer J, Bedrick SD, Boccia K, et al: A pilot prospective feasibility study of organ-at-risk definition using Target Contour Testing/Instructional Computer Software (TaCTICS), a training and evaluation platform for radiotherapy target delineation. AMIA Annu Symp Proc 2011:654–663, 2011 Kalpathy-Cramer J, Bedrick SD, Boccia K, et al: A pilot prospective feasibility study of organ-at-risk definition using Target Contour Testing/Instructional Computer Software (TaCTICS), a training and evaluation platform for radiotherapy target delineation. AMIA Annu Symp Proc 2011:654–663, 2011
53.
go back to reference Feng M, Moran JM, Koelling T, et al: Development and validation of a heart atlas to study cardiac exposure to radiation following treatment for breast cancer. Int J Radiat Oncol Biol Phys 79:10–18, 2011PubMedCentralPubMedCrossRef Feng M, Moran JM, Koelling T, et al: Development and validation of a heart atlas to study cardiac exposure to radiation following treatment for breast cancer. Int J Radiat Oncol Biol Phys 79:10–18, 2011PubMedCentralPubMedCrossRef
54.
go back to reference Malone S, Croke J, Roustan-Delatour N, et al: Postoperative radiotherapy for prostate cancer: a comparison of four consensus guidelines and dosimetric evaluation of 3D-CRT versus tomotherapy IMRT. Int J Radiat Oncol Biol Phys 84:725–732, 2012 Malone S, Croke J, Roustan-Delatour N, et al: Postoperative radiotherapy for prostate cancer: a comparison of four consensus guidelines and dosimetric evaluation of 3D-CRT versus tomotherapy IMRT. Int J Radiat Oncol Biol Phys 84:725–732, 2012
55.
go back to reference Lim K, Small Jr, W, Portelance L, et al: Consensus guidelines for delineation of clinical target volume for intensity-modulated pelvic radiotherapy for the definitive treatment of cervix cancer. Int J Radiat Oncol Biol Phys 79:348–355, 2011PubMedCrossRef Lim K, Small Jr, W, Portelance L, et al: Consensus guidelines for delineation of clinical target volume for intensity-modulated pelvic radiotherapy for the definitive treatment of cervix cancer. Int J Radiat Oncol Biol Phys 79:348–355, 2011PubMedCrossRef
56.
go back to reference Matzinger O, Poortmans P, Giraud JY, et al: Quality assurance in the 22991 EORTC ROG trial in localized prostate cancer: dummy run and individual case review. Radiother Oncol: J Eur Soc Ther Radiol Oncol 90:285–290, 2009CrossRef Matzinger O, Poortmans P, Giraud JY, et al: Quality assurance in the 22991 EORTC ROG trial in localized prostate cancer: dummy run and individual case review. Radiother Oncol: J Eur Soc Ther Radiol Oncol 90:285–290, 2009CrossRef
57.
go back to reference Yamazaki H, Nishiyama K, Tanaka E, et al: Dummy run for a phase II multi-institute trial of chemoradiotherapy for unresectable pancreatic cancer: inter-observer variance in contour delineation. Anticancer Res 27:2965–2971, 2007PubMed Yamazaki H, Nishiyama K, Tanaka E, et al: Dummy run for a phase II multi-institute trial of chemoradiotherapy for unresectable pancreatic cancer: inter-observer variance in contour delineation. Anticancer Res 27:2965–2971, 2007PubMed
58.
go back to reference Clark CH, Miles EA, Urbano MT, et al: Pre-trial quality assurance processes for an intensity-modulated radiation therapy (IMRT) trial: PARSPORT, a UK multicentre phase III trial comparing conventional radiotherapy and parotid-sparing IMRT for locally advanced head and neck cancer. Br J Radiol 82:585–594, 2009PubMedCrossRef Clark CH, Miles EA, Urbano MT, et al: Pre-trial quality assurance processes for an intensity-modulated radiation therapy (IMRT) trial: PARSPORT, a UK multicentre phase III trial comparing conventional radiotherapy and parotid-sparing IMRT for locally advanced head and neck cancer. Br J Radiol 82:585–594, 2009PubMedCrossRef
59.
go back to reference Pawlicki T, Yoo S, Court LE, et al: Process control analysis of IMRT QA: implications for clinical trials. Phys Med Biol 53:5193–5205, 2008PubMedCrossRef Pawlicki T, Yoo S, Court LE, et al: Process control analysis of IMRT QA: implications for clinical trials. Phys Med Biol 53:5193–5205, 2008PubMedCrossRef
Metadata
Title
Development of a Software for Quantitative Evaluation Radiotherapy Target and Organ-at-Risk Segmentation Comparison
Authors
Jayashree Kalpathy-Cramer
Musaddiq Awan
Steven Bedrick
Coen R. N. Rasch
David I. Rosenthal
Clifton D. Fuller
Publication date
01-02-2014
Publisher
Springer US
Published in
Journal of Imaging Informatics in Medicine / Issue 1/2014
Print ISSN: 2948-2925
Electronic ISSN: 2948-2933
DOI
https://doi.org/10.1007/s10278-013-9633-4

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