Prospective assessment of an atlas-based intervention combined with real-time software feedback in contouring lymph node levels and organs-at-risk in the head and neck: Quantitative assessment of conformance to expert delineation
Prospective assessment of an atlas-based intervention combined with real-time software feedback in contouring lymph node levels and organs-at-risk in the head and neck: Quantitative assessment of conformance to expert delineation
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DOI：
10.1016/j.prro.2012.11.002
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发表时间：
2013-07-01
影响因子：
3.3
通讯作者：
Fuller, Clifton D.
中科院分区：
文献类型：
--
作者：
Awan, Musaddiq;Kalpathy-Cramer, Jayashree;Fuller, Clifton D.
目的：之前有多项研究评估了教学干预措施在改善危及器官 (OAR) 描绘方面的作用。我们提出了一项初步研究，证明结合图谱和基于软件的实时反馈干预有助于塑造头颈部 OAR 的轮廓。方法和材料：该研究包括基线评估、实时反馈干预、图谱演示和后续评估。在基线评估时，8 位常驻观察员在没有干预或帮助的情况下通过计算机断层扫描扫描了 26 个 OAR 的轮廓。然后，他们收到反馈，将其轮廓与一组基于图集的专家轮廓进行统计和图形比较。此外，他们还获得了地图集来绘制这些结构的轮廓。然后，驻地观察员被要求通过图集访问在单独的计算机断层扫描中绘制相同的 26 个 OAR 的轮廓。此外，6 名专家（5 名专门研究头颈部的放射肿瘤学家和 1 名神经放射学家）在两次扫描中绘制了 26 个 OAR 的轮廓。专家轮廓的同时真实性和绩效水平估计 (STAPLE) 组合被用作 OAR 轮廓分析的黄金标准集。结果：在最初参与研究的 8 名常驻观察员中，有 7 人完成了研究的两个阶段。计算每个用户绘制的结构相对于每个结构的专家 STAPLE 组合的骰子相似系数。对于每个常驻观察者，所有结构的平均骰子相似系数在第 1 阶段和第 2 阶段之间有所增加，这表明总体 OAR 轮廓能力有统计学上的显着改善 (P
Purpose: A number of studies have previously assessed the role of teaching interventions to improve organ-at-risk (OAR) delineation. We present a preliminary study demonstrating the benefit of a combined atlas and real time software-based feedback intervention to aid in contouring of OARs in the head and neck.Methods and Materials: The study consisted of a baseline evaluation, a real-time feedback intervention, atlas presentation, and a follow-up evaluation. At baseline evaluation, 8 resident observers contoured 26 OARs on a computed tomography scan without intervention or aid. They then received feedback comparing their contours both statistically and graphically to a set of atlasbased expert contours. Additionally, they received access to an atlas to contour these structures. The resident observers were then asked to contour the same 26 OARs on a separate computed tomography scan with atlas access. In addition, 6 experts (5 radiation oncologists specializing in the head and neck, and 1 neuroradiologist) contoured the 26 OARs on both scans. A simultaneous truth and performance level estimation (STAPLE) composite of the expert contours was used as a gold-standard set for analysis of OAR contouring.Results: Of the 8 resident observers who initially participated in the study, 7 completed both phases of the study. Dice similarity coefficients were calculated for each user-drawn structure relative to the expert STAPLE composite for each structure. Mean dice similarity coefficients across all structures increased between phase 1 and phase 2 for each resident observer, demonstrating a statistically significant improvement in overall OAR-contouring ability (P