Influence of experience and qualification on PET-based target volume delineation When there is no expert-ask your colleague
Influence of experience and qualification on PET-based target volume delineation When there is no expert-ask your colleague
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DOI：
10.1007/s00066-014-0644-y
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发表时间：
2014-06-01
影响因子：
3.1
通讯作者：
Nestle, U.
中科院分区：
文献类型：
--
作者：
Doll, C.;Duncker-Rohr, V.;Nestle, U.
背景和目的。在放射治疗计划中，整合正电子发射断层扫描(PET)信息来描绘靶区体积是许多中心的常规做法。与自动等高线绘制相比，视觉-人工勾画的研究很少。本研究调查了手工描绘对经验和资格的依赖性。共有44名国际跨学科观察员使用相同的肺癌患者的PET/CT扫描定义了基于[F-18]氟脱氧葡萄糖(FDG)-PET的大体肿瘤体积(GTV)。观察员包括“专家”(E；n=3)、“有经验的跨学科合作伙伴”(EP；9个放射肿瘤学家(RO)+核医学内科医生(NP))、“单一领域专家”(SFS；n=13)和“学生”(S；n=10)。还包括五种自动描绘方法(AM)。计算体积大小和组内一致性指数(PCI)和相对于专家的一致性指数(ECI)。E(pCI=0.67)和EP(pCI=0.53)组内的一致性显著高于SFS(pCI=0.43，p=0.03和p=0.006)。在与专家的关系上，EP(ECI=0.55)的一致性好于SFS(ECI=0.49)或S(ECI=0.47)。AM的方法间变异性(pCI=0.44)与SFS和S的方法间变异性相似，与专家的一致性较差(ECI=0.35)。结果表明，跨学科合作可能有利于保持一致的轮廓。与其他专家相比，放射肿瘤学家和核医学内科医生的联合描绘显示出与专家的显著一致和更好的一致性。自动算法的相关方法间可变性突出表明，有必要在这一领域进一步标准化和优化。
Backgroung and purpose. The integration of positron emission tomography (PET) information for target volume delineation in radiation treatment planning is routine in many centers. In contrast to automatic contouring, research on visual-manual delineation is scarce. The present study investigates the dependency of manual delineation on experience and qualification.Patients and methods. A total of 44 international interdisciplinary observers each defined a [F-18]fluorodeoxyglucose (FDG)-PET based gross tumor volume (GTV) using the same PET/CT scan from a patient with lung cancer. The observers were "experts" (E; n = 3), "experienced interdisciplinary pairs" (EP; 9 teams of radiation oncologist (RO) + nuclear medicine physician (NP)), "single field specialists" (SFS; n = 13), and "students" (S; n = 10). Five automatic delineation methods (AM) were also included. Volume sizes and concordance indices within the groups (pCI) and relative to the experts (eCI) were calculated.Resuklts. E (pCI = 0.67) and EP (pCI = 0.53) showed a significantly higher agreement within the groups as compared to SFS (pCI = 0.43, p = 0.03, and p = 0.006). In relation to the experts, EP (eCI = 0.55) showed better concordance compared to SFS (eCI = 0.49) or S (eCI = 0.47). The intermethod variability of the AM (pCI = 0.44) was similar to that of SFS and S, showing poorer agreement with the experts (eCI = 0.35).Conclusion. The results suggest that interdisciplinary cooperation could be beneficial for consistent contouring. Joint delineation by a radiation oncologist and a nuclear medicine physician showed remarkable agreement and better concordance with the experts compared to other specialists. The relevant intermethod variability of the automatic algorithms underlines the need for further standardization and optimization in this field.