Abstract
| Original language | English |
|---|---|
| Journal | Br. J. Radiol. |
| Volume | 94 |
| Issue number | 1123 |
| DOIs | |
| Publication status | Published - 2021 |
Keywords
- axilla
- breast tumor
- clinical trial
- female
- human
- Italy
- lymph node metastasis
- multicenter study
- observer variation
- pathology
- procedures
- radiotherapy planning system
- Axilla
- Breast Neoplasms
- Female
- Humans
- Lymphatic Metastasis
- Observer Variation
- Radiotherapy Planning, Computer-Assisted
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Geometric contour variation in clinical target volume of axillary lymph nodes in breast cancer radiotherapy: an AIRO multi-institutional study : British Journal of Radiology. / Leonardi, M.C.; Pepa, M.; Gugliandolo, S.G. et al.
In: Br. J. Radiol., Vol. 94, No. 1123, 2021.Research output: Contribution to journal › Article › peer-review
}
TY - JOUR
T1 - Geometric contour variation in clinical target volume of axillary lymph nodes in breast cancer radiotherapy: an AIRO multi-institutional study
T2 - British Journal of Radiology
AU - Leonardi, M.C.
AU - Pepa, M.
AU - Gugliandolo, S.G.
AU - Luraschi, R.
AU - Vigorito, S.
AU - Rojas, D.P.
AU - la Porta, M.R.
AU - Cante, D.
AU - Petrucci, E.
AU - Marino, L.
AU - Borzì, G.
AU - Ippolito, E.
AU - Marrocco, M.
AU - Huscher, A.
AU - Chieregato, M.
AU - Argenone, A.
AU - Iadanza, L.
AU - de Rose, F.
AU - Lobefalo, F.
AU - Cucciarelli, F.
AU - Valenti, M.
AU - de Santis, M.C.
AU - Cavallo, A.
AU - Rossi, F.
AU - Russo, S.
AU - Prisco, A.
AU - Guernieri, M.
AU - Guarnaccia, R.
AU - Malatesta, T.
AU - Meaglia, I.
AU - Liotta, M.
AU - de Fatis, P.T.
AU - Palumbo, I.
AU - Marcantonini, M.
AU - Colangione, S.P.
AU - Mezzenga, E.
AU - Falivene, S.
AU - Mormile, M.
AU - Ravo, V.
AU - Arrichiello, C.
AU - Fozza, A.
AU - Barbero, M.P.
AU - Ivaldi, G.B.
AU - Catalano, G.
AU - Vidali, C.
AU - Aristei, C.
AU - Giannitto, C.
AU - Miglietta, E.
AU - Ciabattoni, A.
AU - Meattini, I.
AU - Orecchia, R.
AU - Cattani, F.
AU - Jereczek-Fossa, B.A.
N1 - Export Date: 15 October 2021 CODEN: BJRAA Correspondence Address: Rojas, D.P.; Division of Radiation Oncology, Italy; email: damarojas@gmail.com Funding details: Ministero della Salute Funding details: Associazione Italiana per la Ricerca sul Cancro, AIRC, IG-14300 Funding text 1: This work was partially supported by the Italian Ministry of Health with Ricerca Corrente and 5x1000 funds. MP and EM were supported by a research grant from Accuray Inc. entitled “Data collection and analysis of Tomotherapy and CyberKnife breast clinical studies, breast physics studies and prostate study”. SGG was partially supported by Associazione Italiana per la Ricerca sul Cancro (AIRC), project IG-14300 “Carbon ions boost followed by pelvic photon intensity modulated radiotherapy for high-risk prostate cancer”, registered at ClinicalTrials. gov (NCT02672449), approved by IEO R86/14-IEO 98. LJI is a PhD student at the European School of Molecular Medicine (SEMM), Milan, Italy. The sponsors did not play any role in the study design, collection, analysis and interpretation of data, nor in the writing of the manuscript, nor in the decision to submit the manuscript for publication. The authors thank the Scientific Committee and Board of the Italian Association of Radiotherapy and Clinical Oncology (AIRO) for the critical revision of the paper. We would like to thank the following for their contributions to the work: Anna Morra, Maria Alessia Zerella, Johannes Lars Isaksson, Delia Ciardo. References: Cox, S, Cleves, A, Clementel, E, Miles, E, Staffurth, J, Gwynne, S., Impact of deviations in target volume delineation - Time for a new RTQA approach? 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PY - 2021
Y1 - 2021
N2 - Objectives: To determine interobserver variability in axillary nodal contouring in breast cancer (BC) radiotherapy (RT) by comparing the clinical target volume of participating single centres (SC-CTV) with a gold-standard CTV (GS-CTV). Methods: The GS-CTV of three patients (P1, P2, P3) with increasing complexity was created in DICOM format from the median contour of axillary CTVs drawn by BC experts, validated using the simultaneous truth and performance-level estimation and peer-reviewed. GS-CTVs were compared with the correspondent SC-CTVs drawn by radiation oncologists, using validated metrics and a total score (TS) integrating all of them. Results: Eighteen RT centres participated in the study. Comparative analyses revealed that, on average, the SC-CTVs were smaller than GS-CTV for P1 and P2 (by −29.25% and −27.83%, respectively) and larger for P3 (by +12.53%). The mean Jaccard index was greater for P1 and P2 compared to P3, but the overlap extent value was around 0.50 or less. Regarding nodal levels, L4 showed the highest concordance with the GS. In the intra-patient comparison, L2 and L3 achieved lower TS than L4. Nodal levels showed discrepancy with GS, which was not statistically significant for P1, and negligible for P2, while P3 had the worst agreement. DICE similarity coefficient did not exceed the minimum threshold for agreement of 0.70 in all the measurements. Conclusions: Substantial differences were observed between SC- and GS-CTV, especially for P3 with altered arm setup. L2 and L3 were the most critical levels. The study highlighted these key points to address. Advances in knowledge The present study compares, by means of validated geometric indexes, manual segmentations of axillary lymph nodes in breast cancer from different observers and different institutions made on radiotherapy planning CT images. Assessing such variability is of paramount importance, as geometric uncertainties might lead to incorrect dosimetry and compromise oncological outcome. © 2021 The Authors. Published by the British Institute of Radiology
AB - Objectives: To determine interobserver variability in axillary nodal contouring in breast cancer (BC) radiotherapy (RT) by comparing the clinical target volume of participating single centres (SC-CTV) with a gold-standard CTV (GS-CTV). Methods: The GS-CTV of three patients (P1, P2, P3) with increasing complexity was created in DICOM format from the median contour of axillary CTVs drawn by BC experts, validated using the simultaneous truth and performance-level estimation and peer-reviewed. GS-CTVs were compared with the correspondent SC-CTVs drawn by radiation oncologists, using validated metrics and a total score (TS) integrating all of them. Results: Eighteen RT centres participated in the study. Comparative analyses revealed that, on average, the SC-CTVs were smaller than GS-CTV for P1 and P2 (by −29.25% and −27.83%, respectively) and larger for P3 (by +12.53%). The mean Jaccard index was greater for P1 and P2 compared to P3, but the overlap extent value was around 0.50 or less. Regarding nodal levels, L4 showed the highest concordance with the GS. In the intra-patient comparison, L2 and L3 achieved lower TS than L4. Nodal levels showed discrepancy with GS, which was not statistically significant for P1, and negligible for P2, while P3 had the worst agreement. DICE similarity coefficient did not exceed the minimum threshold for agreement of 0.70 in all the measurements. Conclusions: Substantial differences were observed between SC- and GS-CTV, especially for P3 with altered arm setup. L2 and L3 were the most critical levels. The study highlighted these key points to address. Advances in knowledge The present study compares, by means of validated geometric indexes, manual segmentations of axillary lymph nodes in breast cancer from different observers and different institutions made on radiotherapy planning CT images. Assessing such variability is of paramount importance, as geometric uncertainties might lead to incorrect dosimetry and compromise oncological outcome. © 2021 The Authors. Published by the British Institute of Radiology
KW - axilla
KW - breast tumor
KW - clinical trial
KW - female
KW - human
KW - Italy
KW - lymph node metastasis
KW - multicenter study
KW - observer variation
KW - pathology
KW - procedures
KW - radiotherapy planning system
KW - Axilla
KW - Breast Neoplasms
KW - Female
KW - Humans
KW - Lymphatic Metastasis
KW - Observer Variation
KW - Radiotherapy Planning, Computer-Assisted
U2 - 10.1259/bjr.20201177
DO - 10.1259/bjr.20201177
M3 - Article
SN - 0007-1285
VL - 94
JO - Br. J. Radiol.
JF - Br. J. Radiol.
IS - 1123
ER -