Assessment of organs-at-risk contouring practices in radiosurgery institutions around the world - The first initiative of the OAR Standardization Working Group
2016 (English)In: Radiotherapy and Oncology, ISSN 0167-8140, E-ISSN 1879-0887, Vol. 121, no 2, 180-186 p.Article in journal (Refereed) Published
Materials and methods
Imaging datasets for typical lesions (cavernous sinus meningioma, vestibular schwannoma, pituitary adenoma) treated with Leksell Gamma Knife Perfexion were circulated to 12 centers. Observers were asked to contour the target and OARs as per their standard clinical practice. The analyzed parameters were the intersection (AV100), union volumes (AV100/N) and the 50% agreement volume (AV50). The ratio of AV100 and AV100/N (the Agreement Volume Index, AVI) was used as a measure of agreement level together with a generalized conformity index (CIgen) and a pairwise averaged conformity index (CIpairs). The maximum doses were also determined.
Results showed a wide variability in terminology, choice of structures contoured and in the size and shape of the contoured structures. The highest variability was observed for the left and right optic tract for cavernous sinus meningioma where the AV100 was zero. The highest consistency was observed for the right optic nerve in the cavernous sinus case followed by the cochlea for the vestibular schwannoma case for which the AVI was still only 0.13 and 0.054, respectively. Corresponding results for the CIgen and CIpairs also showed the highest variability for the right optic tract and the highest consistency in contours for the right optic nerve, both in the cavernous sinus meningioma case.
The results quantify the large variability in OAR contouring in clinical practice across Gamma Knife radiosurgery centers with respect to the choice of OARs to be contoured, nomenclature and size and shape of OARs. This motivates future effort to standardize practices to enable more effective collaboration.
Place, publisher, year, edition, pages
2016. Vol. 121, no 2, 180-186 p.
Optic nerve, Chiasm, Cochlea, Stereotactic radiosurgery, Inter-observer variability
Cancer and Oncology
Research subject Medical Radiation Physics
IdentifiersURN: urn:nbn:se:su:diva-135331DOI: 10.1016/j.radonc.2016.10.014PubMedID: 27816408OAI: oai:DiVA.org:su-135331DiVA: diva2:1044574