Harmonization of the Volume of Interest Delineation among All Eleven Radiotherapy Centers in the North of France.
BACKGROUND:Inter-observer delineation variation has been detailed for many years in almost every tumor location. Inadequate delineation can impair the chance of cure and/or increase toxicity. The aim of our original work was to prospectively improve the homogeneity of delineation among all of the se...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2016-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC4795685?pdf=render |
| _version_ | 1818457232195452928 |
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| author | David Pasquier Laurence Boutaud de la Combe-Chossiere Damien Carlier Franck Darloy Anne Catherine Degrendel-Courtecuisse Chantal Dufour Mustapha Fares Laurent Gilbeau Xavier Liem Philippe Martin Pascal Meyer Jean François Minne Olimpia Olszyk Hassan Rhliouch Marc Tokarski Chloé Viot Bernard Castelain Eric Lartigau |
| author_facet | David Pasquier Laurence Boutaud de la Combe-Chossiere Damien Carlier Franck Darloy Anne Catherine Degrendel-Courtecuisse Chantal Dufour Mustapha Fares Laurent Gilbeau Xavier Liem Philippe Martin Pascal Meyer Jean François Minne Olimpia Olszyk Hassan Rhliouch Marc Tokarski Chloé Viot Bernard Castelain Eric Lartigau |
| author_sort | David Pasquier |
| collection | DOAJ |
| description | BACKGROUND:Inter-observer delineation variation has been detailed for many years in almost every tumor location. Inadequate delineation can impair the chance of cure and/or increase toxicity. The aim of our original work was to prospectively improve the homogeneity of delineation among all of the senior radiation oncologists in the Nord-Pas de Calais region, irrespective of the conditions of practice. METHODS:All 11 centers were involved. The first studied cancer was prostate cancer. Three clinical cases were studied: a low-risk prostate cancer case (case 1), a high-risk prostate cancer case (pelvic nodes, case 2) and a case of post-operative biochemical elevated PSA (case 3). All of the involved physicians delineated characteristically the clinical target volume (CTV) and organs at risk. The volumes were compared using validated indexes: the volume ratio (VR), common and additional volumes (CV and AV), volume overlap (VO) and Dice similarity coefficient (DSC). A second delineation of the same three cases was performed after discussion of the slice results and the choice of shared guidelines to evaluate homogenization. A comparative analysis of the indexes before and after discussion was conducted using the Wilcoxon test for paired samples. A p-value less than 0.05 was considered to indicate statistical significance. RESULTS:The indexes were not improved in case 1, for which the inter-observer agreement was considered good after the first comparison (DSC = 0.83 ± 0.06). In case 2, the second comparison showed homogenization of the CTV delineation with a significant improvement in CV (81.4 ± 11.7 vs. 88.6 ± 10.26, respectively, p = 0.048), VO (0.41 ± 0.09 vs. 0.47 ± 0.07, respectively; p = 0.009) and DSC (0.58 ± 0.09 vs. 0.63 ± 0.07, respectively; p = 0.0098). In case 3, VR and AV were significantly improved: VR: 1.71(± 0.6) vs. 1.34(± 0.46), respectively, p = 0.0034; AV: 46.58(± 14.50) vs. 38.08(± 15.10), respectively, p = 0.0024. DSC was not improved, but it was already superior to 0.6 in the first comparison. CONCLUSION:Our prospective work showed that a collaborative discussion about clinical cases and the choice of shared guidelines within an established framework improved the homogeneity of CTV delineation among the senior radiation oncologists in our region. |
| first_indexed | 2024-12-14T22:39:17Z |
| format | Article |
| id | doaj.art-ecac985adde44ba580109ac011254eb9 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-14T22:39:17Z |
| publishDate | 2016-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-ecac985adde44ba580109ac011254eb92022-12-21T22:45:02ZengPublic Library of Science (PLoS)PLoS ONE1932-62032016-01-01113e015091710.1371/journal.pone.0150917Harmonization of the Volume of Interest Delineation among All Eleven Radiotherapy Centers in the North of France.David PasquierLaurence Boutaud de la Combe-ChossiereDamien CarlierFranck DarloyAnne Catherine Degrendel-CourtecuisseChantal DufourMustapha FaresLaurent GilbeauXavier LiemPhilippe MartinPascal MeyerJean François MinneOlimpia OlszykHassan RhliouchMarc TokarskiChloé ViotBernard CastelainEric LartigauBACKGROUND:Inter-observer delineation variation has been detailed for many years in almost every tumor location. Inadequate delineation can impair the chance of cure and/or increase toxicity. The aim of our original work was to prospectively improve the homogeneity of delineation among all of the senior radiation oncologists in the Nord-Pas de Calais region, irrespective of the conditions of practice. METHODS:All 11 centers were involved. The first studied cancer was prostate cancer. Three clinical cases were studied: a low-risk prostate cancer case (case 1), a high-risk prostate cancer case (pelvic nodes, case 2) and a case of post-operative biochemical elevated PSA (case 3). All of the involved physicians delineated characteristically the clinical target volume (CTV) and organs at risk. The volumes were compared using validated indexes: the volume ratio (VR), common and additional volumes (CV and AV), volume overlap (VO) and Dice similarity coefficient (DSC). A second delineation of the same three cases was performed after discussion of the slice results and the choice of shared guidelines to evaluate homogenization. A comparative analysis of the indexes before and after discussion was conducted using the Wilcoxon test for paired samples. A p-value less than 0.05 was considered to indicate statistical significance. RESULTS:The indexes were not improved in case 1, for which the inter-observer agreement was considered good after the first comparison (DSC = 0.83 ± 0.06). In case 2, the second comparison showed homogenization of the CTV delineation with a significant improvement in CV (81.4 ± 11.7 vs. 88.6 ± 10.26, respectively, p = 0.048), VO (0.41 ± 0.09 vs. 0.47 ± 0.07, respectively; p = 0.009) and DSC (0.58 ± 0.09 vs. 0.63 ± 0.07, respectively; p = 0.0098). In case 3, VR and AV were significantly improved: VR: 1.71(± 0.6) vs. 1.34(± 0.46), respectively, p = 0.0034; AV: 46.58(± 14.50) vs. 38.08(± 15.10), respectively, p = 0.0024. DSC was not improved, but it was already superior to 0.6 in the first comparison. CONCLUSION:Our prospective work showed that a collaborative discussion about clinical cases and the choice of shared guidelines within an established framework improved the homogeneity of CTV delineation among the senior radiation oncologists in our region.http://europepmc.org/articles/PMC4795685?pdf=render |
| spellingShingle | David Pasquier Laurence Boutaud de la Combe-Chossiere Damien Carlier Franck Darloy Anne Catherine Degrendel-Courtecuisse Chantal Dufour Mustapha Fares Laurent Gilbeau Xavier Liem Philippe Martin Pascal Meyer Jean François Minne Olimpia Olszyk Hassan Rhliouch Marc Tokarski Chloé Viot Bernard Castelain Eric Lartigau Harmonization of the Volume of Interest Delineation among All Eleven Radiotherapy Centers in the North of France. PLoS ONE |
| title | Harmonization of the Volume of Interest Delineation among All Eleven Radiotherapy Centers in the North of France. |
| title_full | Harmonization of the Volume of Interest Delineation among All Eleven Radiotherapy Centers in the North of France. |
| title_fullStr | Harmonization of the Volume of Interest Delineation among All Eleven Radiotherapy Centers in the North of France. |
| title_full_unstemmed | Harmonization of the Volume of Interest Delineation among All Eleven Radiotherapy Centers in the North of France. |
| title_short | Harmonization of the Volume of Interest Delineation among All Eleven Radiotherapy Centers in the North of France. |
| title_sort | harmonization of the volume of interest delineation among all eleven radiotherapy centers in the north of france |
| url | http://europepmc.org/articles/PMC4795685?pdf=render |
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