An evaluation of the variability of tumor-shape definition derived by experienced observers from CT images of supraglottic carcinomas (ACRIN protocol 6658)
An evaluation of the variability of tumor-shape definition derived by experienced observers from CT images of supraglottic carcinomas (ACRIN protocol 6658)
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DOI：
10.1016/j.ijrobp.2006.10.029
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发表时间：
2007-03-15
影响因子：
7
通讯作者：
Sicks, JoRean
中科院分区：
文献类型：
--
作者：
Cooper, Jay S.;Mukherji, Suresh K.;Sicks, JoRean
目的：准确的靶区定义对于复杂的图像引导放射治疗至关重要；然而，衡量我们准确识别目标精确形状的能力的信息相对较少。我们决定评估八位“专家”基于“现实生活”对比增强计算机断层扫描 (CT) 扫描解释肿瘤大小和形状的方式。方法和材料：四位神经放射科医生和四位放射肿瘤学家（作者）在治疗头颈肿瘤方面拥有丰富的经验和假定的专业知识，逐层独立绘制轮廓，他/她对 20 组 CT 扫描中每组的精确大体肿瘤体积 (GTV) 的解释来自先前参加放射治疗肿瘤学组方案 91-11 的 20 名患者。 结果：重叠的平均比例（即一致程度）为 0.532（95% 置信区间 0.457 至 0.606）。随着平均 GTV 的增加，重叠比例略有增加。结论：我们的工作表明，即使对于经验丰富的医生来说，目前对肿瘤形状的估计也是不精确的。因此，目前较小的油田和更紧的利润的趋势似乎存在实际限制。 (c) 2007 爱思唯尔公司
Purpose: Accurate target definition is considered essential for sophisticated, image-guided radiation therapy; however, relatively little information has been reported that measures our ability to identify the precise shape of targets accurately. We decided to assess the manner in which eight "experts" interpreted the size and shape of tumors based on "real-life" contrast-enhanced computed tomographic (CT) scans.Methods and Materials: Four neuroradiologists and four radiation oncologists (the authors) with considerable experience and presumed expertise in treating head-and-neck tumors independently contoured, slice-by-slice, his/her interpretation of the precise gross tumor volume (GTV) on each of 20 sets of CT scans taken from 20 patients who previously were enrolled in Radiation Therapy Oncology Group protocol 91-11.Results: The average proportion of overlap (i.e., the degree of agreement) was 0.532 (95% confidence interval 0.457 to 0.606). There was a slight tendency for the proportion of overlap to increase with increasing average GTV.Conclusions: Our work suggests that estimation of tumor shape currently is imprecise, even for experienced physicians. In consequence, there appears to be a practical limit to the current trend of smaller fields and tighter margins. (c) 2007 Elsevier Inc.