Interobserver variability in target definition for stereotactic arrhythmia radioablation
BackgroundStereotactic arrhythmia radioablation (STAR) is a potential new therapy for patients with refractory ventricular tachycardia (VT). The arrhythmogenic substrate (target) is synthesized from clinical and electro-anatomical information. This study was designed to evaluate the baseline interob...
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Frontiers Media S.A.
2023-09-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1267800/full |
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| author | Martijn H. van der Ree Martijn H. van der Ree Phillip S. Cuculich Marcel van Herk Geoffrey D. Hugo Jippe C. Balt Matthew Bates Gordon Ho Etienne Pruvot Claudia Herrera-Siklody Wiert F. Hoeksema Wiert F. Hoeksema Justin Lee Michael S. Lloyd Michiel J. B. Kemme Michiel J. B. Kemme Frederic Sacher Romain Tixier Joost J. C. Verhoeff Brian V. Balgobind Clifford G. Robinson Coen R. N. Rasch Pieter G. Postema Pieter G. Postema |
| author_facet | Martijn H. van der Ree Martijn H. van der Ree Phillip S. Cuculich Marcel van Herk Geoffrey D. Hugo Jippe C. Balt Matthew Bates Gordon Ho Etienne Pruvot Claudia Herrera-Siklody Wiert F. Hoeksema Wiert F. Hoeksema Justin Lee Michael S. Lloyd Michiel J. B. Kemme Michiel J. B. Kemme Frederic Sacher Romain Tixier Joost J. C. Verhoeff Brian V. Balgobind Clifford G. Robinson Coen R. N. Rasch Pieter G. Postema Pieter G. Postema |
| author_sort | Martijn H. van der Ree |
| collection | DOAJ |
| description | BackgroundStereotactic arrhythmia radioablation (STAR) is a potential new therapy for patients with refractory ventricular tachycardia (VT). The arrhythmogenic substrate (target) is synthesized from clinical and electro-anatomical information. This study was designed to evaluate the baseline interobserver variability in target delineation for STAR.MethodsDelineation software designed for research purposes was used. The study was split into three phases. Firstly, electrophysiologists delineated a well-defined structure in three patients (spinal canal). Secondly, observers delineated the VT-target in three patients based on case descriptions. To evaluate baseline performance, a basic workflow approach was used, no advanced techniques were allowed. Thirdly, observers delineated three predefined segments from the 17-segment model. Interobserver variability was evaluated by assessing volumes, variation in distance to the median volume expressed by the root-mean-square of the standard deviation (RMS-SD) over the target volume, and the Dice-coefficient.ResultsTen electrophysiologists completed the study. For the first phase interobserver variability was low as indicated by low variation in distance to the median volume (RMS-SD range: 0.02–0.02 cm) and high Dice-coefficients (mean: 0.97 ± 0.01). In the second phase distance to the median volume was large (RMS-SD range: 0.52–1.02 cm) and the Dice-coefficients low (mean: 0.40 ± 0.15). In the third phase, similar results were observed (RMS-SD range: 0.51–1.55 cm, Dice-coefficient mean: 0.31 ± 0.21).ConclusionsInterobserver variability is high for manual delineation of the VT-target and ventricular segments. This evaluation of the baseline observer variation shows that there is a need for methods and tools to improve variability and allows for future comparison of interventions aiming to reduce observer variation, for STAR but possibly also for catheter ablation. |
| first_indexed | 2024-03-11T23:12:36Z |
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| id | doaj.art-8e5247be46124debb3412f7b4ecbf351 |
| institution | Directory Open Access Journal |
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| language | English |
| last_indexed | 2024-03-11T23:12:36Z |
| publishDate | 2023-09-01 |
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| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-8e5247be46124debb3412f7b4ecbf3512023-09-21T07:08:29ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2023-09-011010.3389/fcvm.2023.12678001267800Interobserver variability in target definition for stereotactic arrhythmia radioablationMartijn H. van der Ree0Martijn H. van der Ree1Phillip S. Cuculich2Marcel van Herk3Geoffrey D. Hugo4Jippe C. Balt5Matthew Bates6Gordon Ho7Etienne Pruvot8Claudia Herrera-Siklody9Wiert F. Hoeksema10Wiert F. Hoeksema11Justin Lee12Michael S. Lloyd13Michiel J. B. Kemme14Michiel J. B. Kemme15Frederic Sacher16Romain Tixier17Joost J. C. Verhoeff18Brian V. Balgobind19Clifford G. Robinson20Coen R. N. Rasch21Pieter G. Postema22Pieter G. Postema23Department of Cardiology, Amsterdam UMC Location University of Amsterdam, Amsterdam, NetherlandsDepartment of Cardiology, Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias, Amsterdam, NetherlandsDepartment of Internal Medicine, Cardiovascular Division, Washington University School of Medicine, St. Louis, MO, United StatesDepartment of Radiation Oncology, Manchester Academic Health Centre, University of Manchester, Manchester, United KingdomDepartment of Radiation Oncology, Washington University School of Medicine, St. Louis, MO, United StatesDepartment of Cardiology, St. Antonius Hospital, Nieuwegein, NetherlandsDepartment of Cardiology, South Tees Hospitals NHS Foundation Trust, Middleborough, United KingdomDepartment of Medicine, Division of Cardiology Cardiac Electrophysiology, Cardiovascular Institute, University of California San Diego, San Diego, CA, United StatesHeart and Vessel Department, Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, SwitzerlandHeart and Vessel Department, Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, SwitzerlandDepartment of Cardiology, Amsterdam UMC Location University of Amsterdam, Amsterdam, NetherlandsDepartment of Cardiology, Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias, Amsterdam, Netherlands0Department of Immunity, Infection and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom1Section of Cardiac Electrophysiology, Emory University, Atlanta, GA, United StatesDepartment of Cardiology, Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias, Amsterdam, Netherlands2Department of Cardiology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands3Cardiac Arrhythmia Department, IHU LIRYC, Bordeaux University Hospital, Bordeaux, France3Cardiac Arrhythmia Department, IHU LIRYC, Bordeaux University Hospital, Bordeaux, France4Department of Radiation Oncology, UMC Utrecht, Utrecht, Netherlands5Department of Radiation Oncology, Amsterdam UMC, Amsterdam, NetherlandsDepartment of Radiation Oncology, Washington University School of Medicine, St. Louis, MO, United States6Department of Radiation Oncology, LUMC, Leiden, NetherlandsDepartment of Cardiology, Amsterdam UMC Location University of Amsterdam, Amsterdam, NetherlandsDepartment of Cardiology, Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias, Amsterdam, NetherlandsBackgroundStereotactic arrhythmia radioablation (STAR) is a potential new therapy for patients with refractory ventricular tachycardia (VT). The arrhythmogenic substrate (target) is synthesized from clinical and electro-anatomical information. This study was designed to evaluate the baseline interobserver variability in target delineation for STAR.MethodsDelineation software designed for research purposes was used. The study was split into three phases. Firstly, electrophysiologists delineated a well-defined structure in three patients (spinal canal). Secondly, observers delineated the VT-target in three patients based on case descriptions. To evaluate baseline performance, a basic workflow approach was used, no advanced techniques were allowed. Thirdly, observers delineated three predefined segments from the 17-segment model. Interobserver variability was evaluated by assessing volumes, variation in distance to the median volume expressed by the root-mean-square of the standard deviation (RMS-SD) over the target volume, and the Dice-coefficient.ResultsTen electrophysiologists completed the study. For the first phase interobserver variability was low as indicated by low variation in distance to the median volume (RMS-SD range: 0.02–0.02 cm) and high Dice-coefficients (mean: 0.97 ± 0.01). In the second phase distance to the median volume was large (RMS-SD range: 0.52–1.02 cm) and the Dice-coefficients low (mean: 0.40 ± 0.15). In the third phase, similar results were observed (RMS-SD range: 0.51–1.55 cm, Dice-coefficient mean: 0.31 ± 0.21).ConclusionsInterobserver variability is high for manual delineation of the VT-target and ventricular segments. This evaluation of the baseline observer variation shows that there is a need for methods and tools to improve variability and allows for future comparison of interventions aiming to reduce observer variation, for STAR but possibly also for catheter ablation.https://www.frontiersin.org/articles/10.3389/fcvm.2023.1267800/fullcardiac radioablationstereotactic arrhythmia radiotherapystereotactic arrhythmia radioablationventricular tachycardiainterobserver variability |
| spellingShingle | Martijn H. van der Ree Martijn H. van der Ree Phillip S. Cuculich Marcel van Herk Geoffrey D. Hugo Jippe C. Balt Matthew Bates Gordon Ho Etienne Pruvot Claudia Herrera-Siklody Wiert F. Hoeksema Wiert F. Hoeksema Justin Lee Michael S. Lloyd Michiel J. B. Kemme Michiel J. B. Kemme Frederic Sacher Romain Tixier Joost J. C. Verhoeff Brian V. Balgobind Clifford G. Robinson Coen R. N. Rasch Pieter G. Postema Pieter G. Postema Interobserver variability in target definition for stereotactic arrhythmia radioablation Frontiers in Cardiovascular Medicine cardiac radioablation stereotactic arrhythmia radiotherapy stereotactic arrhythmia radioablation ventricular tachycardia interobserver variability |
| title | Interobserver variability in target definition for stereotactic arrhythmia radioablation |
| title_full | Interobserver variability in target definition for stereotactic arrhythmia radioablation |
| title_fullStr | Interobserver variability in target definition for stereotactic arrhythmia radioablation |
| title_full_unstemmed | Interobserver variability in target definition for stereotactic arrhythmia radioablation |
| title_short | Interobserver variability in target definition for stereotactic arrhythmia radioablation |
| title_sort | interobserver variability in target definition for stereotactic arrhythmia radioablation |
| topic | cardiac radioablation stereotactic arrhythmia radiotherapy stereotactic arrhythmia radioablation ventricular tachycardia interobserver variability |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1267800/full |
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