Improvement in Interobserver Accuracy in Delineation of the Lumpectomy Cavity Using Fiducial Markers
Purpose To determine, whether the presence of gold fiducial markers would improve the inter- and intraphysician accuracy in the delineation of the surgical cavity compared with a matched group of patients who did not receive gold fiducial markers in the setting of accelerated partial-breast irradiat...
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| creator | Shaikh, Talha, B.S Chen, Ting, Ph.D Khan, Atif, M.D Yue, Ning J., Ph.D Kearney, Thomas, M.D Cohler, Alan, M.D Haffty, Bruce G., M.D Goyal, Sharad, M.D |
| description | Purpose To determine, whether the presence of gold fiducial markers would improve the inter- and intraphysician accuracy in the delineation of the surgical cavity compared with a matched group of patients who did not receive gold fiducial markers in the setting of accelerated partial-breast irradiation (APBI). Methods and Materials Planning CT images of 22 lumpectomy cavities were reviewed in a cohort of 22 patients; 11 patients received four to six gold fiducial markers placed at the time of surgery. Three physicians categorized the seroma cavity according to cavity visualization score criteria and delineated each of the 22 seroma cavities and the clinical target volume. Distance between centers of mass, percentage overlap, and average surface distance for all patients were assessed. Results The mean seroma volume was 36.9 cm3 and 34.2 cm3 for fiducial patients and non-fiducial patients, respectively ( p = ns). Fiducial markers improved the mean cavity visualization score, to 3.6 ± 1.0 from 2.5 ± 1.3 ( p < 0.05). The mean distance between centers of mass, average surface distance, and percentage overlap for the seroma and clinical target volume were significantly improved in the fiducial marker patients as compared with the non-fiducial marker patients ( p < 0.001). Conclusions The placement of gold fiducial markers placed at the time of lumpectomy improves interphysician identification and delineation of the seroma cavity and clinical target volume. This has implications in radiotherapy treatment planning for accelerated partial-breast irradiation and for boost after whole-breast irradiation. |
| doi_str_mv | 10.1016/j.ijrobp.2009.09.025 |
| format | Article |
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Methods and Materials Planning CT images of 22 lumpectomy cavities were reviewed in a cohort of 22 patients; 11 patients received four to six gold fiducial markers placed at the time of surgery. Three physicians categorized the seroma cavity according to cavity visualization score criteria and delineated each of the 22 seroma cavities and the clinical target volume. Distance between centers of mass, percentage overlap, and average surface distance for all patients were assessed. Results The mean seroma volume was 36.9 cm3 and 34.2 cm3 for fiducial patients and non-fiducial patients, respectively ( p = ns). Fiducial markers improved the mean cavity visualization score, to 3.6 ± 1.0 from 2.5 ± 1.3 ( p < 0.05). The mean distance between centers of mass, average surface distance, and percentage overlap for the seroma and clinical target volume were significantly improved in the fiducial marker patients as compared with the non-fiducial marker patients ( p < 0.001). Conclusions The placement of gold fiducial markers placed at the time of lumpectomy improves interphysician identification and delineation of the seroma cavity and clinical target volume. This has implications in radiotherapy treatment planning for accelerated partial-breast irradiation and for boost after whole-breast irradiation.</description><identifier>ISSN: 0360-3016</identifier><identifier>EISSN: 1879-355X</identifier><identifier>DOI: 10.1016/j.ijrobp.2009.09.025</identifier><identifier>PMID: 20304565</identifier><identifier>CODEN: IOBPD3</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Aged ; Biological and medical sciences ; BODY ; Breast cancer ; Breast Neoplasms - diagnostic imaging ; Breast Neoplasms - pathology ; Breast Neoplasms - radiotherapy ; Breast Neoplasms - surgery ; Carcinoma in Situ - diagnostic imaging ; Carcinoma in Situ - pathology ; Carcinoma in Situ - radiotherapy ; Carcinoma in Situ - surgery ; Carcinoma, Ductal, Breast - diagnostic imaging ; Carcinoma, Ductal, Breast - pathology ; Carcinoma, Ductal, Breast - radiotherapy ; Carcinoma, Ductal, Breast - surgery ; CAT SCANNING ; CAVITIES ; COMPUTERIZED TOMOGRAPHY ; Delineation ; DIAGNOSTIC TECHNIQUES ; DISEASES ; Female ; Fiducial markers ; GLANDS ; Gold ; Gynecology. Andrology. Obstetrics ; Hematology, Oncology and Palliative Medicine ; Humans ; Mammary gland diseases ; MAMMARY GLANDS ; Mastectomy, Segmental ; Medical sciences ; MEDICINE ; Middle Aged ; NEOPLASMS ; NUCLEAR MEDICINE ; Observer Variation ; ORGANS ; PLANNING ; Prospective Studies ; Prostheses and Implants ; RADIOLOGY ; RADIOLOGY AND NUCLEAR MEDICINE ; RADIOTHERAPY ; Radiotherapy, Conformal ; Seroma - diagnostic imaging ; Seroma - pathology ; Seroma cavity ; SURGERY ; THERAPY ; TOMOGRAPHY ; Tomography, X-Ray Computed ; Tumor Burden ; Tumors</subject><ispartof>International journal of radiation oncology, biology, physics, 2010-11, Vol.78 (4), p.1127-1134</ispartof><rights>Elsevier Inc.</rights><rights>2010 Elsevier Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2010 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-6b161bfb81049bf3fc9e4daca34848a0f68b1f226550b5f32b8c6bbb4265ab623</citedby><cites>FETCH-LOGICAL-c474t-6b161bfb81049bf3fc9e4daca34848a0f68b1f226550b5f32b8c6bbb4265ab623</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ijrobp.2009.09.025$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,777,781,882,3537,27905,27906,45976</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23387482$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20304565$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://www.osti.gov/biblio/21438049$$D View this record in Osti.gov$$Hfree_for_read</backlink></links><search><creatorcontrib>Shaikh, Talha, B.S</creatorcontrib><creatorcontrib>Chen, Ting, Ph.D</creatorcontrib><creatorcontrib>Khan, Atif, M.D</creatorcontrib><creatorcontrib>Yue, Ning J., Ph.D</creatorcontrib><creatorcontrib>Kearney, Thomas, M.D</creatorcontrib><creatorcontrib>Cohler, Alan, M.D</creatorcontrib><creatorcontrib>Haffty, Bruce G., M.D</creatorcontrib><creatorcontrib>Goyal, Sharad, M.D</creatorcontrib><title>Improvement in Interobserver Accuracy in Delineation of the Lumpectomy Cavity Using Fiducial Markers</title><title>International journal of radiation oncology, biology, physics</title><addtitle>Int J Radiat Oncol Biol Phys</addtitle><description>Purpose To determine, whether the presence of gold fiducial markers would improve the inter- and intraphysician accuracy in the delineation of the surgical cavity compared with a matched group of patients who did not receive gold fiducial markers in the setting of accelerated partial-breast irradiation (APBI). Methods and Materials Planning CT images of 22 lumpectomy cavities were reviewed in a cohort of 22 patients; 11 patients received four to six gold fiducial markers placed at the time of surgery. Three physicians categorized the seroma cavity according to cavity visualization score criteria and delineated each of the 22 seroma cavities and the clinical target volume. Distance between centers of mass, percentage overlap, and average surface distance for all patients were assessed. Results The mean seroma volume was 36.9 cm3 and 34.2 cm3 for fiducial patients and non-fiducial patients, respectively ( p = ns). Fiducial markers improved the mean cavity visualization score, to 3.6 ± 1.0 from 2.5 ± 1.3 ( p < 0.05). The mean distance between centers of mass, average surface distance, and percentage overlap for the seroma and clinical target volume were significantly improved in the fiducial marker patients as compared with the non-fiducial marker patients ( p < 0.001). Conclusions The placement of gold fiducial markers placed at the time of lumpectomy improves interphysician identification and delineation of the seroma cavity and clinical target volume. This has implications in radiotherapy treatment planning for accelerated partial-breast irradiation and for boost after whole-breast irradiation.</description><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>BODY</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - diagnostic imaging</subject><subject>Breast Neoplasms - pathology</subject><subject>Breast Neoplasms - radiotherapy</subject><subject>Breast Neoplasms - surgery</subject><subject>Carcinoma in Situ - diagnostic imaging</subject><subject>Carcinoma in Situ - pathology</subject><subject>Carcinoma in Situ - radiotherapy</subject><subject>Carcinoma in Situ - surgery</subject><subject>Carcinoma, Ductal, Breast - diagnostic imaging</subject><subject>Carcinoma, Ductal, Breast - pathology</subject><subject>Carcinoma, Ductal, Breast - radiotherapy</subject><subject>Carcinoma, Ductal, Breast - surgery</subject><subject>CAT SCANNING</subject><subject>CAVITIES</subject><subject>COMPUTERIZED TOMOGRAPHY</subject><subject>Delineation</subject><subject>DIAGNOSTIC TECHNIQUES</subject><subject>DISEASES</subject><subject>Female</subject><subject>Fiducial markers</subject><subject>GLANDS</subject><subject>Gold</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Hematology, Oncology and Palliative Medicine</subject><subject>Humans</subject><subject>Mammary gland diseases</subject><subject>MAMMARY GLANDS</subject><subject>Mastectomy, Segmental</subject><subject>Medical sciences</subject><subject>MEDICINE</subject><subject>Middle Aged</subject><subject>NEOPLASMS</subject><subject>NUCLEAR MEDICINE</subject><subject>Observer Variation</subject><subject>ORGANS</subject><subject>PLANNING</subject><subject>Prospective Studies</subject><subject>Prostheses and Implants</subject><subject>RADIOLOGY</subject><subject>RADIOLOGY AND NUCLEAR MEDICINE</subject><subject>RADIOTHERAPY</subject><subject>Radiotherapy, Conformal</subject><subject>Seroma - diagnostic imaging</subject><subject>Seroma - pathology</subject><subject>Seroma cavity</subject><subject>SURGERY</subject><subject>THERAPY</subject><subject>TOMOGRAPHY</subject><subject>Tomography, X-Ray Computed</subject><subject>Tumor Burden</subject><subject>Tumors</subject><issn>0360-3016</issn><issn>1879-355X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkl2L1DAUhoso7uzqPxApiHjV8eSjXzfCMrrrwIgXuuBdSNJTN902mU3agf57UzoqeCMEAslzPt7zniR5RWBLgBTvu63pvFPHLQWot8uh-ZNkQ6qyzlie_3iabIAVkLEIXySXIXQAQEjJnycXFBjwvMg3SbMfjt6dcEA7psameztizBrQn9Cn11pPXup5-fmIvbEoR-Ns6tp0vMf0MA1H1KMb5nQnT2ac07tg7M_0xjSTNrJPv0j_gD68SJ61sg_48nxfJXc3n77vPmeHr7f73fUh07zkY1YoUhDVqooAr1XLWl0jb6SWjFe8ktAWlSItpUWeg8pbRlWlC6UUjy9SFZRdJW_WvC6MRgRtRtT32lkbmxSUcFbFxJF6t1JR-OOEYRSDCRr7Xlp0UxBlAZQxqMpI8pXU3oXgsRVHbwbpZ0FALCaITqwmiMUEsRyax7DX5wKTGrD5E_R76hF4ewZk0LJvvbTahL8cY1XJq0XPh5XDOLSTQb9oQquxMX6R1Djzv07-TaCjiSbWfMAZQ-cmb6MhgohABYhvy8Is-wI1MEoJsF-oOLxG</recordid><startdate>20101115</startdate><enddate>20101115</enddate><creator>Shaikh, Talha, B.S</creator><creator>Chen, Ting, Ph.D</creator><creator>Khan, Atif, M.D</creator><creator>Yue, Ning J., Ph.D</creator><creator>Kearney, Thomas, M.D</creator><creator>Cohler, Alan, M.D</creator><creator>Haffty, Bruce G., M.D</creator><creator>Goyal, Sharad, M.D</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>OTOTI</scope></search><sort><creationdate>20101115</creationdate><title>Improvement in Interobserver Accuracy in Delineation of the Lumpectomy Cavity Using Fiducial Markers</title><author>Shaikh, Talha, B.S ; Chen, Ting, Ph.D ; Khan, Atif, M.D ; Yue, Ning J., Ph.D ; Kearney, Thomas, M.D ; Cohler, Alan, M.D ; Haffty, Bruce G., M.D ; Goyal, Sharad, M.D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-6b161bfb81049bf3fc9e4daca34848a0f68b1f226550b5f32b8c6bbb4265ab623</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>BODY</topic><topic>Breast cancer</topic><topic>Breast Neoplasms - diagnostic imaging</topic><topic>Breast Neoplasms - pathology</topic><topic>Breast Neoplasms - radiotherapy</topic><topic>Breast Neoplasms - surgery</topic><topic>Carcinoma in Situ - diagnostic imaging</topic><topic>Carcinoma in Situ - pathology</topic><topic>Carcinoma in Situ - radiotherapy</topic><topic>Carcinoma in Situ - surgery</topic><topic>Carcinoma, Ductal, Breast - diagnostic imaging</topic><topic>Carcinoma, Ductal, Breast - pathology</topic><topic>Carcinoma, Ductal, Breast - radiotherapy</topic><topic>Carcinoma, Ductal, Breast - surgery</topic><topic>CAT SCANNING</topic><topic>CAVITIES</topic><topic>COMPUTERIZED TOMOGRAPHY</topic><topic>Delineation</topic><topic>DIAGNOSTIC TECHNIQUES</topic><topic>DISEASES</topic><topic>Female</topic><topic>Fiducial markers</topic><topic>GLANDS</topic><topic>Gold</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Hematology, Oncology and Palliative Medicine</topic><topic>Humans</topic><topic>Mammary gland diseases</topic><topic>MAMMARY GLANDS</topic><topic>Mastectomy, Segmental</topic><topic>Medical sciences</topic><topic>MEDICINE</topic><topic>Middle Aged</topic><topic>NEOPLASMS</topic><topic>NUCLEAR MEDICINE</topic><topic>Observer Variation</topic><topic>ORGANS</topic><topic>PLANNING</topic><topic>Prospective Studies</topic><topic>Prostheses and Implants</topic><topic>RADIOLOGY</topic><topic>RADIOLOGY AND NUCLEAR MEDICINE</topic><topic>RADIOTHERAPY</topic><topic>Radiotherapy, Conformal</topic><topic>Seroma - diagnostic imaging</topic><topic>Seroma - pathology</topic><topic>Seroma cavity</topic><topic>SURGERY</topic><topic>THERAPY</topic><topic>TOMOGRAPHY</topic><topic>Tomography, X-Ray Computed</topic><topic>Tumor Burden</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shaikh, Talha, B.S</creatorcontrib><creatorcontrib>Chen, Ting, Ph.D</creatorcontrib><creatorcontrib>Khan, Atif, M.D</creatorcontrib><creatorcontrib>Yue, Ning J., Ph.D</creatorcontrib><creatorcontrib>Kearney, Thomas, M.D</creatorcontrib><creatorcontrib>Cohler, Alan, M.D</creatorcontrib><creatorcontrib>Haffty, Bruce G., M.D</creatorcontrib><creatorcontrib>Goyal, Sharad, M.D</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>OSTI.GOV</collection><jtitle>International journal of radiation oncology, biology, physics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shaikh, Talha, B.S</au><au>Chen, Ting, Ph.D</au><au>Khan, Atif, M.D</au><au>Yue, Ning J., Ph.D</au><au>Kearney, Thomas, M.D</au><au>Cohler, Alan, M.D</au><au>Haffty, Bruce G., M.D</au><au>Goyal, Sharad, M.D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Improvement in Interobserver Accuracy in Delineation of the Lumpectomy Cavity Using Fiducial Markers</atitle><jtitle>International journal of radiation oncology, biology, physics</jtitle><addtitle>Int J Radiat Oncol Biol Phys</addtitle><date>2010-11-15</date><risdate>2010</risdate><volume>78</volume><issue>4</issue><spage>1127</spage><epage>1134</epage><pages>1127-1134</pages><issn>0360-3016</issn><eissn>1879-355X</eissn><coden>IOBPD3</coden><abstract>Purpose To determine, whether the presence of gold fiducial markers would improve the inter- and intraphysician accuracy in the delineation of the surgical cavity compared with a matched group of patients who did not receive gold fiducial markers in the setting of accelerated partial-breast irradiation (APBI). Methods and Materials Planning CT images of 22 lumpectomy cavities were reviewed in a cohort of 22 patients; 11 patients received four to six gold fiducial markers placed at the time of surgery. Three physicians categorized the seroma cavity according to cavity visualization score criteria and delineated each of the 22 seroma cavities and the clinical target volume. Distance between centers of mass, percentage overlap, and average surface distance for all patients were assessed. Results The mean seroma volume was 36.9 cm3 and 34.2 cm3 for fiducial patients and non-fiducial patients, respectively ( p = ns). Fiducial markers improved the mean cavity visualization score, to 3.6 ± 1.0 from 2.5 ± 1.3 ( p < 0.05). The mean distance between centers of mass, average surface distance, and percentage overlap for the seroma and clinical target volume were significantly improved in the fiducial marker patients as compared with the non-fiducial marker patients ( p < 0.001). Conclusions The placement of gold fiducial markers placed at the time of lumpectomy improves interphysician identification and delineation of the seroma cavity and clinical target volume. This has implications in radiotherapy treatment planning for accelerated partial-breast irradiation and for boost after whole-breast irradiation.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>20304565</pmid><doi>10.1016/j.ijrobp.2009.09.025</doi><tpages>8</tpages></addata></record> |
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| ispartof | International journal of radiation oncology, biology, physics, 2010-11, Vol.78 (4), p.1127-1134 |
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| subjects | Adult Aged Biological and medical sciences BODY Breast cancer Breast Neoplasms - diagnostic imaging Breast Neoplasms - pathology Breast Neoplasms - radiotherapy Breast Neoplasms - surgery Carcinoma in Situ - diagnostic imaging Carcinoma in Situ - pathology Carcinoma in Situ - radiotherapy Carcinoma in Situ - surgery Carcinoma, Ductal, Breast - diagnostic imaging Carcinoma, Ductal, Breast - pathology Carcinoma, Ductal, Breast - radiotherapy Carcinoma, Ductal, Breast - surgery CAT SCANNING CAVITIES COMPUTERIZED TOMOGRAPHY Delineation DIAGNOSTIC TECHNIQUES DISEASES Female Fiducial markers GLANDS Gold Gynecology. Andrology. Obstetrics Hematology, Oncology and Palliative Medicine Humans Mammary gland diseases MAMMARY GLANDS Mastectomy, Segmental Medical sciences MEDICINE Middle Aged NEOPLASMS NUCLEAR MEDICINE Observer Variation ORGANS PLANNING Prospective Studies Prostheses and Implants RADIOLOGY RADIOLOGY AND NUCLEAR MEDICINE RADIOTHERAPY Radiotherapy, Conformal Seroma - diagnostic imaging Seroma - pathology Seroma cavity SURGERY THERAPY TOMOGRAPHY Tomography, X-Ray Computed Tumor Burden Tumors |
| title | Improvement in Interobserver Accuracy in Delineation of the Lumpectomy Cavity Using Fiducial Markers |
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