Internal Guidelines for Reducing Lymph Node Contour Variability in Total Marrow and Lymph Node Irradiation
Background: The total marrow and lymph node irradiation (TMLI) target includes the bones, spleen, and lymph node chains, with the latter being the most challenging structures to contour. We evaluated the impact of introducing internal contour guidelines to reduce the inter- and intraobserver lymph n...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-02-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/15/5/1536 |
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| author | Damiano Dei Nicola Lambri Sara Stefanini Veronica Vernier Ricardo Coimbra Brioso Leonardo Crespi Elena Clerici Luisa Bellu Chiara De Philippis Daniele Loiacono Pierina Navarria Giacomo Reggiori Stefania Bramanti Marcello Rodari Stefano Tomatis Arturo Chiti Carmelo Carlo-Stella Marta Scorsetti Pietro Mancosu |
| author_facet | Damiano Dei Nicola Lambri Sara Stefanini Veronica Vernier Ricardo Coimbra Brioso Leonardo Crespi Elena Clerici Luisa Bellu Chiara De Philippis Daniele Loiacono Pierina Navarria Giacomo Reggiori Stefania Bramanti Marcello Rodari Stefano Tomatis Arturo Chiti Carmelo Carlo-Stella Marta Scorsetti Pietro Mancosu |
| author_sort | Damiano Dei |
| collection | DOAJ |
| description | Background: The total marrow and lymph node irradiation (TMLI) target includes the bones, spleen, and lymph node chains, with the latter being the most challenging structures to contour. We evaluated the impact of introducing internal contour guidelines to reduce the inter- and intraobserver lymph node delineation variability in TMLI treatments. Methods: A total of 10 patients were randomly selected from our database of 104 TMLI patients so as to evaluate the guidelines’ efficacy. The lymph node clinical target volume (CTV_LN) was recontoured according to the guidelines (CTV_LN_GL_RO1) and compared to the historical guidelines (CTV_LN_Old). Both topological (i.e., Dice similarity coefficient (DSC)) and dosimetric (i.e., V95 (the volume receiving 95% of the prescription dose) metrics were calculated for all paired contours. Results: The mean DSCs were 0.82 ± 0.09, 0.97 ± 0.01, and 0.98 ± 0.02, respectively, for CTV_LN_Old vs. CTV_LN_GL_RO1, and between the inter- and intraobserver contours following the guidelines. Correspondingly, the mean CTV_LN-V95 dose differences were 4.8 ± 4.7%, 0.03 ± 0.5%, and 0.1 ± 0.1%. Conclusions: The guidelines reduced the CTV_LN contour variability. The high target coverage agreement revealed that historical CTV-to-planning-target-volume margins were safe, even if a relatively low DSC was observed. |
| first_indexed | 2024-03-11T07:29:05Z |
| format | Article |
| id | doaj.art-bbc20f6d6818433a86e47b4e2711b58c |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-11T07:29:05Z |
| publishDate | 2023-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-bbc20f6d6818433a86e47b4e2711b58c2023-11-17T07:25:24ZengMDPI AGCancers2072-66942023-02-01155153610.3390/cancers15051536Internal Guidelines for Reducing Lymph Node Contour Variability in Total Marrow and Lymph Node IrradiationDamiano Dei0Nicola Lambri1Sara Stefanini2Veronica Vernier3Ricardo Coimbra Brioso4Leonardo Crespi5Elena Clerici6Luisa Bellu7Chiara De Philippis8Daniele Loiacono9Pierina Navarria10Giacomo Reggiori11Stefania Bramanti12Marcello Rodari13Stefano Tomatis14Arturo Chiti15Carmelo Carlo-Stella16Marta Scorsetti17Pietro Mancosu18Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milan, ItalyDepartment of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milan, ItalyDepartment of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milan, ItalyDepartment of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milan, ItalyDipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, 20133 Milan, ItalyDipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, 20133 Milan, ItalyDepartment of Radiotherapy and Radiosurgery, IRCCS Humanitas Research Hospital, via Manzoni 56, Rozzano, 20089 Milan, ItalyDepartment of Radiotherapy and Radiosurgery, IRCCS Humanitas Research Hospital, via Manzoni 56, Rozzano, 20089 Milan, ItalyDepartment of Oncology and Hematology, IRCCS Humanitas Research Hospital, via Manzoni 56, Rozzano, 20089 Milan, ItalyDipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, 20133 Milan, ItalyDepartment of Radiotherapy and Radiosurgery, IRCCS Humanitas Research Hospital, via Manzoni 56, Rozzano, 20089 Milan, ItalyDepartment of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milan, ItalyDepartment of Oncology and Hematology, IRCCS Humanitas Research Hospital, via Manzoni 56, Rozzano, 20089 Milan, ItalyDepartment of Nuclear Medicine, IRCCS Humanitas Research Hospital, via Manzoni 56, Rozzano, 20089 Milan, ItalyDepartment of Radiotherapy and Radiosurgery, IRCCS Humanitas Research Hospital, via Manzoni 56, Rozzano, 20089 Milan, ItalyDepartment of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milan, ItalyDepartment of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milan, ItalyDepartment of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milan, ItalyDepartment of Radiotherapy and Radiosurgery, IRCCS Humanitas Research Hospital, via Manzoni 56, Rozzano, 20089 Milan, ItalyBackground: The total marrow and lymph node irradiation (TMLI) target includes the bones, spleen, and lymph node chains, with the latter being the most challenging structures to contour. We evaluated the impact of introducing internal contour guidelines to reduce the inter- and intraobserver lymph node delineation variability in TMLI treatments. Methods: A total of 10 patients were randomly selected from our database of 104 TMLI patients so as to evaluate the guidelines’ efficacy. The lymph node clinical target volume (CTV_LN) was recontoured according to the guidelines (CTV_LN_GL_RO1) and compared to the historical guidelines (CTV_LN_Old). Both topological (i.e., Dice similarity coefficient (DSC)) and dosimetric (i.e., V95 (the volume receiving 95% of the prescription dose) metrics were calculated for all paired contours. Results: The mean DSCs were 0.82 ± 0.09, 0.97 ± 0.01, and 0.98 ± 0.02, respectively, for CTV_LN_Old vs. CTV_LN_GL_RO1, and between the inter- and intraobserver contours following the guidelines. Correspondingly, the mean CTV_LN-V95 dose differences were 4.8 ± 4.7%, 0.03 ± 0.5%, and 0.1 ± 0.1%. Conclusions: The guidelines reduced the CTV_LN contour variability. The high target coverage agreement revealed that historical CTV-to-planning-target-volume margins were safe, even if a relatively low DSC was observed.https://www.mdpi.com/2072-6694/15/5/1536TMLIguidelinesradiotherapyinterobserver variabilitycontour definitionclinical target volume |
| spellingShingle | Damiano Dei Nicola Lambri Sara Stefanini Veronica Vernier Ricardo Coimbra Brioso Leonardo Crespi Elena Clerici Luisa Bellu Chiara De Philippis Daniele Loiacono Pierina Navarria Giacomo Reggiori Stefania Bramanti Marcello Rodari Stefano Tomatis Arturo Chiti Carmelo Carlo-Stella Marta Scorsetti Pietro Mancosu Internal Guidelines for Reducing Lymph Node Contour Variability in Total Marrow and Lymph Node Irradiation Cancers TMLI guidelines radiotherapy interobserver variability contour definition clinical target volume |
| title | Internal Guidelines for Reducing Lymph Node Contour Variability in Total Marrow and Lymph Node Irradiation |
| title_full | Internal Guidelines for Reducing Lymph Node Contour Variability in Total Marrow and Lymph Node Irradiation |
| title_fullStr | Internal Guidelines for Reducing Lymph Node Contour Variability in Total Marrow and Lymph Node Irradiation |
| title_full_unstemmed | Internal Guidelines for Reducing Lymph Node Contour Variability in Total Marrow and Lymph Node Irradiation |
| title_short | Internal Guidelines for Reducing Lymph Node Contour Variability in Total Marrow and Lymph Node Irradiation |
| title_sort | internal guidelines for reducing lymph node contour variability in total marrow and lymph node irradiation |
| topic | TMLI guidelines radiotherapy interobserver variability contour definition clinical target volume |
| url | https://www.mdpi.com/2072-6694/15/5/1536 |
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