Interobserver variability in organ at risk delineation in head and neck cancer.
Interobserver variability in organ at risk delineation in head and neck cancer.
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DOI：
10.1186/s13014-020-01677-2
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发表时间：
2021-06-28
期刊：
影响因子：
--
通讯作者：
Nuyts S
中科院分区：
文献类型：
--
作者：
van der Veen J;Gulyban A;Willems S;Maes F;Nuyts S
在放射治疗中，危险器官(OAR)描述的不准确会影响治疗计划的优化和治疗计划的评估。布劳威尔等人。在头颈癌(HNC)的OAR描述中显示出显著的观察者间变异性(IOV)，并于2015年发布了OAR描述的国际共识指南(ICG)。我们研究的目的是在存在这些指南的情况下评估IOV。来自比利时每个放射治疗中心的HNC放射肿瘤学家(RO)被邀请完成一项调查，并提交5例HNC病例的轮廓。参考轮廓(OARref)是通过临床验证的人工智能工具获得的，该工具使用ICG进行训练。采用骰子相似系数(DSC)、平均表面距离(MSD)和95%Hausdorff距离(HD95)进行比较。22名注册主任中有14名(%)完成了调查并提交了分界线。13人(93%)确认使用划定指南，其中6人(43%)使用ICG。与OARREF最符合的桨分别为下颌[DSC 0.9中位数(0.8~0.9)；MSD1.1 mm中位数(0.8~8.3)，HD95 3.4 mm中位数(1.5~38.7)]，脑干DSC 0.9(0.6~0.9)；颌下腺[DSC中位数0.8(0.5~0.9)；MSD中位数1.2 mm(0.9~2.5)，HD95中位数3.1 mm(1.8~12.2)]；腮腺[DSC中位数0.9(0.6~0.9)；中位数MSD 1.9 mm(1.2-4.2)，中位数HD95 5.1 mm(3.1-19.2)]。口腔、耳蜗区、PCM、声门上喉区、声门区变异较大。使用共识指南的RO显示IOV显著减少(p = 0.008)。尽管在HNC中存在划桨的ICG，但只有大约一半的参与研究的RO实施了ICG，这在一定程度上解释了划桨的可变性。然而，这项研究强调，仅有指南不足以消除IOV，需要做出更多努力来实现进一步的治疗标准化，例如使用人工智能。补充信息见10.1186/s13014-020-01677-2。
In radiotherapy inaccuracy in organ at risk (OAR) delineation can impact treatment plan optimisation and treatment plan evaluation. Brouwer et al. showed significant interobserver variability (IOV) in OAR delineation in head and neck cancer (HNC) and published international consensus guidelines (ICG) for OAR delineation in 2015. The aim of our study was to evaluate IOV in the presence of these guidelines. HNC radiation oncologists (RO) from each Belgian radiotherapy centre were invited to complete a survey and submit contours for 5 HNC cases. Reference contours (OARref) were obtained by a clinically validated artificial intelligence-tool trained using ICG. Dice similarity coefficients (DSC), mean surface distance (MSD) and 95% Hausdorff distances (HD95) were used for comparison. Fourteen of twenty-two RO (64%) completed the survey and submitted delineations. Thirteen (93%) confirmed the use of delineation guidelines, of which six (43%) used the ICG. The OARs whose delineations agreed best with the OARref were mandible [median DSC 0.9, range (0.8–0.9); median MSD 1.1 mm, range (0.8–8.3), median HD95 3.4 mm, range (1.5–38.7)], brainstem [median DSC 0.9 (0.6–0.9); median MSD 1.5 mm (1.1–4.0), median HD95 4.0 mm (2.3–15.0)], submandibular glands [median DSC 0.8 (0.5–0.9); median MSD 1.2 mm (0.9–2.5), median HD95 3.1 mm (1.8–12.2)] and parotids [median DSC 0.9 (0.6–0.9); median MSD 1.9 mm (1.2–4.2), median HD95 5.1 mm (3.1–19.2)]. Oral cavity, cochleas, PCMs, supraglottic larynx and glottic area showed more variation. RO who used the consensus guidelines showed significantly less IOV (p = 0.008). Although ICG for delineation of OARs in HNC exist, they are only implemented by about half of RO participating in this study, which partly explains the delineation variability. However, this study highlights that guidelines alone do not suffice to eliminate IOV and that more effort needs to be done to accomplish further treatment standardisation, for example with artificial intelligence. Supplementary information accompanies this paper at 10.1186/s13014-020-01677-2.
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影响因子：
5.7
作者：
Due, Anne K.;Vogelius, Ivan R.;Specht, Lena
通讯作者：
Specht, Lena
DOI：
10.1016/s0360-3016(97)00853-5
发表时间：
1998-02-01
影响因子：
7
作者：
Hermans, R;Feron, M;Baert, AL
通讯作者：
Baert, AL
DOI：
10.1016/s0360-3016(01)01751-5
发表时间：
2002-01-01
影响因子：
7
作者：
Rasch, C;Eisbruch, A;Lebesque, JV
通讯作者：
Lebesque, JV
DOI：
10.1186/1748-717x-7-32
发表时间：
2012-03-13
期刊：
Radiation oncology (London, England)
影响因子：
--
作者：
Brouwer CL;Steenbakkers RJ;van den Heuvel E;Duppen JC;Navran A;Bijl HP;Chouvalova O;Burlage FR;Meertens H;Langendijk JA;van 't Veld AA
通讯作者：
van 't Veld AA
影响因子：
2.6
作者：
Mukesh, M.;Benson, R.;Jefferies, S.
通讯作者：
Jefferies, S.