Inter- and intra-observer variation in soft-tissue sarcoma target definition
To evaluate inter- and intra-observer variability in gross tumor volume definition for adult limb/trunk soft tissue sarcomas. Imaging studies of 15 patients previously treated with preoperative radiation were used in this study. Five physicians (radiation oncologists, orthopedic surgeons and a muscu...
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Veröffentlicht in: | Cancer radiothérapie 2011-08, Vol.15 (5), p.421-425 |
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Zusammenfassung: | To evaluate inter- and intra-observer variability in gross tumor volume definition for adult limb/trunk soft tissue sarcomas.
Imaging studies of 15 patients previously treated with preoperative radiation were used in this study. Five physicians (radiation oncologists, orthopedic surgeons and a musculoskeletal radiologist) were asked to contour each of the 15 tumors on T1-weighted, gadolinium-enhanced magnetic resonance images. These contours were drawn twice by each physician. The volume and center of mass coordinates for each gross tumor volume were extracted and a Boolean analysis was performed to measure the degree of volume overlap.
The median standard deviation in gross tumor volumes across observers was 6.1% of the average volume (range: 1.8%–24.9%). There was remarkably little variation in the 3D position of the gross tumor volume center of mass. For the 15 patients, the standard deviation of the 3D distance between centers of mass ranged from 0.06
mm to 1.7
mm (median 0.1
mm). Boolean analysis demonstrated that 53% to 90% of the gross tumor volume was common to all observers (median overlap: 79%). The standard deviation in gross tumor volumes on repeat contouring was 4.8% (range: 0.1–14.4%) with a standard deviation change in the position of the center of mass of 0.4
mm (range: 0
mm–2.6
mm) and a median overlap of 93% (range: 73%–98%).
Although significant inter-observer differences were seen in gross tumor volume definition of adult soft-tissue sarcoma, the center of mass of these volumes was remarkably consistent. Variations in volume definition did not correlate with tumor size. Radiation oncologists should not hesitate to review their contours with a colleague (surgeon, radiologist or fellow radiation oncologist) to ensure that they are not outliers in sarcoma gross tumor volume definition. Protocols should take into account variations in volume definition when considering tighter clinical target volumes.
Évaluer les variations inter- et intra-observateur dans la délinéation des volumes tumoraux macroscopiques pour les sarcomes des tissus mous des membres et du tronc de patients adultes.
L’imagerie de 15 patients après radiothérapie et avant chirurgie a été utilisée pour cette étude. Cinq observateurs (deux oncologues radiothérapeutes, deux orthopédistes et un radiologiste spécialisé en imagerie musculosquelettique) ont délinéé chacune des 15 tumeurs à deux reprises à au moins un mois d’intervalle. Ces contours ont été faits sur des images remn |
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ISSN: | 1278-3218 1769-6658 |
DOI: | 10.1016/j.canrad.2011.03.006 |