Delineation uncertainties of tumour volumes on MRI of head and neck cancer patients
Background: During the last decade, radiotherapy using MR Linac has gone from research to clinical implementation for different cancer locations. For head and neck cancer (HNC), target delineation based only on MR images is not yet standard, and the utilisation of MRI instead of PET/CT in radiothera...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-09-01
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| Series: | Clinical and Translational Radiation Oncology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405630822000672 |
| _version_ | 1811281306154172416 |
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| author | Ruta Zukauskaite Christopher N. Rumley Christian R. Hansen Michael G. Jameson Yuvnik Trada Jørgen Johansen Niels Gyldenkerne Jesper G. Eriksen Farhannah Aly Rasmus L. Christensen Mark Lee Carsten Brink Lois Holloway |
| author_facet | Ruta Zukauskaite Christopher N. Rumley Christian R. Hansen Michael G. Jameson Yuvnik Trada Jørgen Johansen Niels Gyldenkerne Jesper G. Eriksen Farhannah Aly Rasmus L. Christensen Mark Lee Carsten Brink Lois Holloway |
| author_sort | Ruta Zukauskaite |
| collection | DOAJ |
| description | Background: During the last decade, radiotherapy using MR Linac has gone from research to clinical implementation for different cancer locations. For head and neck cancer (HNC), target delineation based only on MR images is not yet standard, and the utilisation of MRI instead of PET/CT in radiotherapy planning is not well established. We aimed to analyse the inter-observer variation (IOV) in delineating GTV (gross tumour volume) on MR images only for patients with HNC. Material/methods: 32 HNC patients from two independent departments were included. Four clinical oncologists from Denmark and four radiation oncologists from Australia had independently contoured primary tumour GTVs (GTV-T) and nodal GTVs (GTV-N) on T2-weighted MR images obtained at the time of treatment planning. Observers were provided with sets of images, delineation guidelines and patient synopsis. Simultaneous truth and performance level estimation (STAPLE) reference volumes were generated for each structure using all observer contours. The IOV was assessed using the DICE Similarity Coefficient (DSC) and mean absolute surface distance (MASD). Results: 32 GTV-Ts and 68 GTV-Ns were contoured per observer. The median MASD for GTV-Ts and GTV-Ns across all patients was 0.17 cm (range 0.08–0.39 cm) and 0.07 cm (range 0.04–0.33 cm), respectively. Median DSC relative to a STAPLE volume for GTV-Ts and GTV-Ns across all patients were 0.73 and 0.76, respectively. A significant correlation was seen between median DSCs and median volumes of GTV-Ts (Spearman correlation coefficient 0.76, p < 0.001) and of GTV-Ns (Spearman correlation coefficient 0.55, p < 0.001). Conclusion: Contouring GTVs in patients with HNC on MRI showed that the median IOV for GTV-T and GTV-N was below 2 mm, based on observes from two separate radiation departments. However, there are still specific regions in tumours that are difficult to resolve as either malignant tissue or oedema that potentially could be improved by further training in MR-only delineation. |
| first_indexed | 2024-04-13T01:31:24Z |
| format | Article |
| id | doaj.art-c35a7e8bd1694803bc77a7d4282c070d |
| institution | Directory Open Access Journal |
| issn | 2405-6308 |
| language | English |
| last_indexed | 2024-04-13T01:31:24Z |
| publishDate | 2022-09-01 |
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| record_format | Article |
| series | Clinical and Translational Radiation Oncology |
| spelling | doaj.art-c35a7e8bd1694803bc77a7d4282c070d2022-12-22T03:08:30ZengElsevierClinical and Translational Radiation Oncology2405-63082022-09-0136121126Delineation uncertainties of tumour volumes on MRI of head and neck cancer patientsRuta Zukauskaite0Christopher N. Rumley1Christian R. Hansen2Michael G. Jameson3Yuvnik Trada4Jørgen Johansen5Niels Gyldenkerne6Jesper G. Eriksen7Farhannah Aly8Rasmus L. Christensen9Mark Lee10Carsten Brink11Lois Holloway12Department of Oncology, Odense University Hospital, Kloevervaenget 9, 5000 Odense, Denmark; Ingham Institute for Applied Medical Research, Liverpool & Macarthur Cancer Therapy Centres, SWSLHD Area Cancer Services, Locked Bag 7103, Liverpool BC, NSW 1871, Australia; Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Corresponding author at: Department of Oncology, Odense University Hospital, Sdr. Boulevard 29, 5000 Odense C, Denmark.Ingham Institute for Applied Medical Research, Liverpool & Macarthur Cancer Therapy Centres, SWSLHD Area Cancer Services, Locked Bag 7103, Liverpool BC, NSW 1871, Australia; Department of Radiation Oncology, Townsville University Hospital, QLD AustraliaIngham Institute for Applied Medical Research, Liverpool & Macarthur Cancer Therapy Centres, SWSLHD Area Cancer Services, Locked Bag 7103, Liverpool BC, NSW 1871, Australia; Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Laboratory of Radiation Physics, Department of Oncology, Odense University Hospital, Kloevervaenget 9, 5000 Odense, DenmarkIngham Institute for Applied Medical Research, Liverpool & Macarthur Cancer Therapy Centres, SWSLHD Area Cancer Services, Locked Bag 7103, Liverpool BC, NSW 1871, Australia; South Western Sydney Clinical Campuses, University of New South Wales, Sydney, Australia; GenesisCare, NSW, Australia; St Vincent's Clinical School, University of New South Wales, Sydney, AustraliaIngham Institute for Applied Medical Research, Liverpool & Macarthur Cancer Therapy Centres, SWSLHD Area Cancer Services, Locked Bag 7103, Liverpool BC, NSW 1871, Australia; South Western Sydney Clinical Campuses, University of New South Wales, Sydney, AustraliaDepartment of Oncology, Odense University Hospital, Kloevervaenget 9, 5000 Odense, DenmarkDepartment of Oncology, Odense University Hospital, Kloevervaenget 9, 5000 Odense, DenmarkDepartment of Experimental Clinical Oncology, Aarhus University Hospital, Noerrebrogade 44, Bldg. 5, DK-8000 Aarhus, DenmarkIngham Institute for Applied Medical Research, Liverpool & Macarthur Cancer Therapy Centres, SWSLHD Area Cancer Services, Locked Bag 7103, Liverpool BC, NSW 1871, Australia; South Western Sydney Clinical Campuses, University of New South Wales, Sydney, AustraliaDepartment of Clinical Research, University of Southern Denmark, Odense, Denmark; Laboratory of Radiation Physics, Department of Oncology, Odense University Hospital, Kloevervaenget 9, 5000 Odense, DenmarkIngham Institute for Applied Medical Research, Liverpool & Macarthur Cancer Therapy Centres, SWSLHD Area Cancer Services, Locked Bag 7103, Liverpool BC, NSW 1871, Australia; South Western Sydney Clinical Campuses, University of New South Wales, Sydney, AustraliaDepartment of Clinical Research, University of Southern Denmark, Odense, Denmark; Laboratory of Radiation Physics, Department of Oncology, Odense University Hospital, Kloevervaenget 9, 5000 Odense, DenmarkIngham Institute for Applied Medical Research, Liverpool & Macarthur Cancer Therapy Centres, SWSLHD Area Cancer Services, Locked Bag 7103, Liverpool BC, NSW 1871, Australia; Department of Clinical Research, University of Southern Denmark, Odense, Denmark; South Western Sydney Clinical Campuses, University of New South Wales, Sydney, AustraliaBackground: During the last decade, radiotherapy using MR Linac has gone from research to clinical implementation for different cancer locations. For head and neck cancer (HNC), target delineation based only on MR images is not yet standard, and the utilisation of MRI instead of PET/CT in radiotherapy planning is not well established. We aimed to analyse the inter-observer variation (IOV) in delineating GTV (gross tumour volume) on MR images only for patients with HNC. Material/methods: 32 HNC patients from two independent departments were included. Four clinical oncologists from Denmark and four radiation oncologists from Australia had independently contoured primary tumour GTVs (GTV-T) and nodal GTVs (GTV-N) on T2-weighted MR images obtained at the time of treatment planning. Observers were provided with sets of images, delineation guidelines and patient synopsis. Simultaneous truth and performance level estimation (STAPLE) reference volumes were generated for each structure using all observer contours. The IOV was assessed using the DICE Similarity Coefficient (DSC) and mean absolute surface distance (MASD). Results: 32 GTV-Ts and 68 GTV-Ns were contoured per observer. The median MASD for GTV-Ts and GTV-Ns across all patients was 0.17 cm (range 0.08–0.39 cm) and 0.07 cm (range 0.04–0.33 cm), respectively. Median DSC relative to a STAPLE volume for GTV-Ts and GTV-Ns across all patients were 0.73 and 0.76, respectively. A significant correlation was seen between median DSCs and median volumes of GTV-Ts (Spearman correlation coefficient 0.76, p < 0.001) and of GTV-Ns (Spearman correlation coefficient 0.55, p < 0.001). Conclusion: Contouring GTVs in patients with HNC on MRI showed that the median IOV for GTV-T and GTV-N was below 2 mm, based on observes from two separate radiation departments. However, there are still specific regions in tumours that are difficult to resolve as either malignant tissue or oedema that potentially could be improved by further training in MR-only delineation.http://www.sciencedirect.com/science/article/pii/S2405630822000672Inter-observer variationTarget delineationHead and neck cancerMRI |
| spellingShingle | Ruta Zukauskaite Christopher N. Rumley Christian R. Hansen Michael G. Jameson Yuvnik Trada Jørgen Johansen Niels Gyldenkerne Jesper G. Eriksen Farhannah Aly Rasmus L. Christensen Mark Lee Carsten Brink Lois Holloway Delineation uncertainties of tumour volumes on MRI of head and neck cancer patients Clinical and Translational Radiation Oncology Inter-observer variation Target delineation Head and neck cancer MRI |
| title | Delineation uncertainties of tumour volumes on MRI of head and neck cancer patients |
| title_full | Delineation uncertainties of tumour volumes on MRI of head and neck cancer patients |
| title_fullStr | Delineation uncertainties of tumour volumes on MRI of head and neck cancer patients |
| title_full_unstemmed | Delineation uncertainties of tumour volumes on MRI of head and neck cancer patients |
| title_short | Delineation uncertainties of tumour volumes on MRI of head and neck cancer patients |
| title_sort | delineation uncertainties of tumour volumes on mri of head and neck cancer patients |
| topic | Inter-observer variation Target delineation Head and neck cancer MRI |
| url | http://www.sciencedirect.com/science/article/pii/S2405630822000672 |
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