Interobserver Variability in Target Volume Delineation in Definitive Radiotherapy for Thoracic Esophageal Cancer: a Multi-center Study from China

Overview

Journal Radiat Oncol

Publisher Biomed Central

Specialties Oncology
Radiology

Date 2021 Jun 10

PMID 34107984

Citations 5

Authors

Xiao Chang

Wei Deng

Xin Wang

Zongmei Zhou

Jun Yang

Wenling Guo

Miaoling Liu

Xiaolu Qi

Ling Li

Kaixian Zhang

Min Zhang

Yonggang Shi

Ke Liu

Yidian Zhao

Huitao Wang

Zhilong Yu

Jihong Zhang

Lihua Wang

Xueying Qiao

Chun Han

Shuchai Zhu

Ruohui Zhang

Junqiang Chen

Cairong Hu

Fuquan Zhang

Xiaorong Hou

Qingsong Pang

Wencheng Zhang

Gaofeng Li

Hailei Lin

Xinchen Sun

Xiaolin Ge

Caihong Li

Hong Ge

Dingjie Li

Yadi Wang

Na Lu

Xianshu Gao

Shangbin Qin

Yuan Tian

Zefen Xiao

Affiliations

Soon will be listed here.

Abstract

Purpose: To investigate the interobserver variability (IOV) in target volume delineation of definitive radiotherapy for thoracic esophageal cancer (TEC) among cancer centers in China, and ultimately improve contouring consistency as much as possible to lay the foundation for multi-center prospective studies.

Methods: Sixteen cancer centers throughout China participated in this study. In Phase 1, three suitable cases with upper, middle, and lower TEC were chosen, and participants were asked to contour a group of gross tumor volume (GTV-T), nodal gross tumor volume (GTV-N) and clinical target volume (CTV) for each case based on their routine experience. In Phase 2, the same clinicians were instructed to follow a contouring protocol to re-contour another group of target volume. The variation of the target volume was analyzed and quantified using dice similarity coefficient (DSC).

Results: Sixteen clinicians provided routine volumes, whereas ten provided both routine and protocol volumes for each case. The IOV of routine GTV-N was the most striking in all cases, with the smallest DSC of 0.37 (95% CI 0.32-0.42), followed by CTV, whereas GTV-T showed high consistency. After following the protocol, the smallest DSC of GTV-N was improved to 0.64 (95% CI 0.45-0.83, P = 0.005) but the DSC of GTV-T and CTV remained constant in most cases.

Conclusion: Variability in target volume delineation was observed, but it could be significantly reduced and controlled using mandatory interventions.

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