Top

Published in:

Open Access 01-12-2011 | Research

Quantitative assessment of inter-observer variability in target volume delineation on stereotactic radiotherapy treatment for pituitary adenoma and meningioma near optic tract

Authors: Hideya Yamazaki, Hiroya Shiomi, Takuji Tsubokura, Naohiro Kodani, Takuya Nishimura, Norihiro Aibe, Hiroki Udono, Manabu Nishikata, Yoshimi Baba, Mikio Ogita, Koichi Yamashita, Tadayuki Kotsuma

Published in: Radiation Oncology | Issue 1/2011

Abstract

Background

To assess inter-observer variability in delineating target volume and organs at risk in benign tumor adjacent to optic tract as a quality assurance exercise.

Methods

We quantitatively analyzed 21 plans made by 11 clinicians in seven CyberKnife centers. The clinicians were provided with a raw data set (pituitary adenoma and meningioma) including clinical information, and were asked to delineate the lesions and create a treatment plan. Their contouring and plans (10 adenoma and 11 meningioma plans), were then compared. In addition, we estimated the influence of differences in contouring by superimposing the respective contours onto a default plan.

Results

The median planning target volume (PTV) and the ratio of the largest to the smallest contoured volume were 9.22 cm³ (range, 7.17 - 14.3 cm³) and 1.99 for pituitary adenoma, and 6.86 cm³ (range 6.05 - 14.6 cm³) and 2.41 for meningioma. PTV volume was 10.1 ± 1.74 cm³ for group 1 with a margin of 1 -2 mm around the CTV (n = 3) and 9.28 ± 1.8 cm³(p = 0.51) for group 2 with no margin (n = 7) in pituitary adenoma. In meningioma, group 1 showed larger PTV volume (10.1 ± 3.26 cm³) than group 2 (6.91 ± 0.7 cm³, p = 0.03). All submitted plan keep the irradiated dose to optic tract within the range of 50 Gy (equivalent total doses in 2 Gy fractionation). However, contours superimposed onto the dose distribution of the default plan indicated that an excessive dose 23.64 Gy (up to 268% of the default plan) in pituitary adenoma and 24.84 Gy (131% of the default plan) in meningioma to the optic nerve in the contours from different contouring.

Conclusion

Quality assurance revealed inter-observer variability in contour delineation and their influences on planning for pituitary adenoma and meningioma near optic tract.

Available only for authorised users

Riboldi M, Sharp GC, Baroni G, Chen GT: Four-dimensional targeting error analysis in image-guided radiotherapy. Phys Med Biol 2009, 54: 5995-6008. 10.1088/0031-9155/54/19/022CrossRefPubMed

Yamazaki H, Nishiyama K, Tanaka E, Koiwai K, Shikama N, Ito Y, Arahira S, Tamamoto T, Shibata T, Tamaki Y, Kodaira T, Oguchi M: Dummy run for a phase II multi-institute trial of chemoradiotherapy for unresectable pancreatic cancer: inter-observer variance in contour delineation. Anticancer Res 2007, 27: 2965-71.PubMed

Gandevia B, Stradling P: Observer variation in the tomographic diagnosis of tuberuculous cavitation. Tubercle 1957, 38: 113-22. 10.1016/S0041-3879(57)80005-1CrossRefPubMed

Villeirs GM, Van Vaerenbergh K, Vakaet L, Bral S, Claus F, De Neve WJ, Verstraete KL, De Meerleer GO: Interobserver delineation variation using CT versus combined CT + MRI in intensity-modulated radiotherapy for prostate cancer. Strahlenther Onkol 2005, 181: 424-30. 10.1007/s00066-005-1383-xCrossRefPubMed

Weltens C, Menten J, Feron M, Weltens C, Menten J, Feron M, Bellon E, Demaerel P, Maes F, Van den Bogaert W, van der Schueren E, et al.: Interobserver variations in gross tumor volume delineation of brain tumors on computed tomography and impact of magnetic resonance imaging. Radiother Oncol 2001, 60: 49-59. 10.1016/S0167-8140(01)00371-1CrossRefPubMed

Poortmans PM, Venselaar JL, Struikmans H, Hurkmans CW, Davis JB, Huyskens D, van Tienhoven G, Vlaun V, Lagendijk JJ, Mijnheer BJ, De Winter KA, Van der Hulst MH, Van den Bogaert WF: The potential impact of treatment variations on the results of radiotherapy of the internal mammary lymph node chain: a quality-assurance report on the dummy run of EORTC Phase III randomized trial 22922/10925 in Stage I--III breast cancer. Int J Radiat Oncol Biol Phys 2001, 49: 1399-408. 10.1016/S0360-3016(00)01549-2CrossRefPubMed

Stafford SL, Pollock BE, Foote RL, Link MJ, Gorman DA, Schomberg PJ, Leavitt JA: Meningioma radiosurgery: tumor control, outcomes, and complications among 190 consecutive patients. Neurosurgery 2001, 49: 1029-1037. 10.1097/00006123-200111000-00001PubMed

Erridge SC, Conkey DS, Stockton D, Strachan MW, Statham PF, Whittle IR, Grant R, Kerr GR, Gregor A: Radiotherapy for pituitary adenomas: long-term efficacy and toxicity. Radiother Oncol 2009, 93: 597-601. 10.1016/j.radonc.2009.09.011CrossRefPubMed

Milker-Zabel S, Debus J, Thilmann C, Schlegel W, Wannenmacher M: Fractionated stereotactically guided radiotherapy and radiosurgery in the treatment of functional and nonfunctional adenomas of the pituitary gland. Int J Radiat Oncol Biol Phys 2001, 50: 1279-1286. 10.1016/S0360-3016(01)01535-8CrossRefPubMed

10.

Guideline for radiotherapy planningJapanese society for therapeutic radiology and oncology Japanese College of Radiology, Japan radiological society; [http://www.kkr-smc.com/rad/guideline/2008/]

11.

Emami B, Lyman J, Brown A, Coia L, Goitein M, Munzenrider JE, Shank B, Solin LJ, Wesson M: Tolerance of normal tissue to therapeutic irradiation. Int J Radiat Oncol Biol Phys 1991, 21: 109-22.CrossRefPubMed

12.

Jeanneret-Sozzi W, Moeckli R, Valley JF, Zouhair A, Ozsahin EM, Mirimanoff RO, SASRO: The reasons for discrepancies in target volume delineation: a SASRO study on head-and-neck and prostate cancers. Strahlenther Onkol 2006, 182: 450-7. 10.1007/s00066-006-1463-6CrossRefPubMed

13.

Geets X, Daisne JF, Arcangeli S, Coche E, De Poel M, Duprez T, Nardella G, Grégoire V: Inter-observer variability in the delineation of pharyngo-laryngeal tumor, parotid glands and cervical spinal cord: comparison between CT-scan and MRI. Radiother Oncol 2005, 77: 25-31. 10.1016/j.radonc.2005.04.010CrossRefPubMed

14.

Steenbakkers RJ, Duppen JC, Fitton I, Deurloo KE, Zijp L, Uitterhoeve AL, Rodrigus PT, Kramer GW, Bussink J, De Jaeger K, Belderbos JS, Hart AA, Nowak PJ, van Herk M, Rasch CR: Observer variation in target volume delineation of lung cancer related to radiation oncologist-computer interaction: a 'Big Brother' evaluation. Radiother Oncol 2005, 77: 182-90. 10.1016/j.radonc.2005.09.017CrossRefPubMed

15.

van Sornsen JR, Senan S, Underberg RW, Oei SS, Elshove D, Slotman BJ, Lagerwaard FJ: Use of CD-ROM-based tool for analyzing contouring variations in involved-field radiotherapy for stage III NSCLC. Int J Radiat Oncol Biol Phys 2005, 63: 334-339. 10.1016/j.ijrobp.2005.02.016CrossRef

Title: Quantitative assessment of inter-observer variability in target volume delineation on stereotactic radiotherapy treatment for pituitary adenoma and meningioma near optic tract
Authors: Hideya Yamazaki
Hiroya Shiomi
Takuji Tsubokura
Naohiro Kodani
Takuya Nishimura
Norihiro Aibe
Hiroki Udono
Manabu Nishikata
Yoshimi Baba
Mikio Ogita
Koichi Yamashita
Tadayuki Kotsuma
Publication date: 01-12-2011
Publisher: BioMed Central
Published in: Radiation Oncology / Issue 1/2011
Electronic ISSN: 1748-717X
DOI: https://doi.org/10.1186/1748-717X-6-10

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Quantitative assessment of inter-observer variability in target volume delineation on stereotactic radiotherapy treatment for pituitary adenoma and meningioma near optic tract

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2011

Intensity modulated radiotherapy for elderly bladder cancer patients

Early prediction of response to radiotherapy and androgen-deprivation therapy in prostate cancer by repeated functional MRI: a preclinical study

Recurrence patterns of locally advanced head and neck squamous cell carcinoma after 3D conformal (chemo)-radiotherapy

Commissioning and early experience with a new-generation low-energy linear accelerator with advanced delivery and imaging functionalities

Radiation induced temporal lobe necrosis in patients with nasopharyngeal carcinoma: a review of new avenues in its management

Breathing adapted radiotherapy: a 4D gating software for lung cancer