Interobserver variation in clinical target volume and organs at risk segmentation in post-parotidectomy radiotherapy: can segmentation protocols help?
Interobserver variation in clinical target volume and organs at risk segmentation in post-parotidectomy radiotherapy: can segmentation protocols help?
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DOI：
10.1259/bjr/66693547
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发表时间：
2012-08-01
影响因子：
2.6
通讯作者：
Jefferies, S.
中科院分区：
文献类型：
--
作者：
Mukesh, M.;Benson, R.;Jefferies, S.
目的：对腮腺肿瘤术后临床靶体积（CTV）和危险器官（OAR）分割的观察者间差异进行了研究。分割运动作为基线进行，并重复3个月后使用分割协议，以评估是否CTV符合improved.Methods：四个头部和颈部肿瘤学家独立分割CTVs和OAR（对侧腮腺，脊髓和脑干）的CT数据集腮腺切除术后的5名患者。对于每个CTV或OAR描绘，计算总体积。使用经验证的轮廓分析工具测量不同临床医生轮廓之间的符合性水平（CL）。使用耳蜗保留治疗和传统的放射分割protocol.Results：CTV形态的显着差异，观察到在基线后，产生的平均CL为30%（范围25-39%）的数据进行再分析。使用分割方案后CL改善，平均CL为54%（范围50-65%）。对于OAR，对侧腮腺的平均CL为60%（范围53-68%），脑干为23%（范围13-27%），脊髓为25%（范围22-31%）。结论：不同临床医生之间的CTVs和OAR的一致性较低。使用分割协议后，CTV的CL有所改善，但CL仍低于预期。这项研究支持需要明确的指导方针分割的目标和OAR的比较和解释的头颈部癌症放射研究的结果。
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 reaanalysed 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.