The impact of delineating guideline training on the hippocampal delineation
Chu Jinjin1, Zhu Zhengfei2, Tong Tong3, Yang Xi2, Ni Jianjiao2, Fan Xingwen2
1Department of Radiation Oncology, First Affiliated Hospital of Anhui Medical University,Hefei 230022,China; 2Department of Radiation Oncology, Affiliated Cancer Hospital,Fudan University,Shanghai Medical College,Fudan University, Shanghai 200032,China; 3Department of Radiology, Affiliated Cancer Hospital,Fudan University,Shanghai Medical College,Fudan University,Shanghai 200032,China
Abstract:Objective To explore the differences in the hippocampal delineation among different radiologists and to evaluate the impact of the delineating guideline training upon improving the accuracy of target area. Methods In this prospective study, 20 patients scheduled to receive whole brain radiation therapy were selected. Before and after the delineating guideline training, three physicians from Department of Radiation Oncology delineated the hippocampal targets three times for each patient. One physician from Department of Imaging Diagnosis delivered the delineating guideline training and delineated the hippocampus of 20 patients as the standard target area. The delineating targets before and after the training were statistically compared among different physicians. Results The conformity indexes with the standard target of three physicians before and after the training were 0.66±0.04 and 0.77±0.02,0.62±0.04 and 0.76±0.02,0.49±0.05 and 0.74±0.04,respectively. The conformity indexes were all statistically increased after the training (all P<0.05).The inter-observer variability significantly differed among different physicians before and after training (all P<0.05).The coefficient of variance of hippocampal volume before and after training were 0.16±0.06 and 0.08±0.04 with statistical significance (all P<0.05).Compared with all targets before training, the consistency of each physician was significantly improved after training (all P<0.05). Conclusion Hippocampal delineation guideline training can improve the accuracy of delineation.
Chu Jinjin,Zhu Zhengfei,Tong Tong et al. The impact of delineating guideline training on the hippocampal delineation[J]. Chinese Journal of Radiation Oncology, 2019, 28(2): 81-84.
[1] Nelms BE,ToméWA,RobinsonG,et al. Variations in the contouring of organs at risk:test case from a patient with oropharyngeal cancer[J].Int J Radiat Oncol Biol Phys,2012,82(1):368-78.DOI:10.1016/j.ijrobp.2010.10.019. [2] Rasch C,Eisbruch A,Remeijer P,et al. Irradiation of paranasal sinus tumors,a delineation and dose comparison study[J].Int J Radiat Oncol Biol Phys,2002,52(1):120-127. [3] Feng M,Demiroz C,Vineberg KA,et al. Normal tissue anatomy for oropharyngeal cancer:contouring variability and its impact on optimization[J].Int J Radiat Oncol Biol Phys,2012,84(2):e245-249.DOI:10.1016/j.ijrobp.2012.03.031. [4] Gondi V,Pugh SL,Tome WA,et al. Preservation of memory with conformal avoidance of the hippocampal neural stem-cell compartment during whole-brain radiotherapy for brain metastases (RTOG 0933):a phase Ⅱ multi-institutional trial[J].J Clin Oncol,2014,32(34):3810-3816.DOI:10.1200/JCO.2014.57.2909. [5] Ghia A,Tomé WA,Thomas S,et al. Distribution of brain metastases in relation to the hippocampus:implications for neurocognitive functional preservation[J].Int J Radiat Oncol Biol Phys,2007,68(4):971-977. [6] Chang EL,Wefel JS,Hess KR,et al. Neurocognition in patients with brain metastases treated with radiosurgery or radiosurgery plus whole-brain irradiation:a randomised controlled trail[J].Lancet Oncol, 2009,10(11):1037-44.DOI:10.1016/S1470-2045(09)70263-3. [7] Barani IJ,Benedict SH,Lin PS.Neural stem cells:implications for the conventional radiotherapy of central nervous system malignancies[J].Int J Radiat Oncol Biol Phys,2007,68(2):324-333. [8] Acharya NM,Christic LA,Lan ML,et al. Human neural stem cell transplantation ameliorates radiation-induced conitive dysfuction[J].Cancer Res,2011,71(14):4834-45.DOI:10.1158/0008-5472.CAN-11-0027. [9] Hurkmans CW,Borger JH,Pieters BR,et al. Variability in target volume delineation on CT scans of the breast[J].Int J Radiat Oncol Biol Phys,2001,50(5):1366-1372. [10] Wong EK,Truong PT,Kader HA,et al. Consistency in seroma contouring for partial breast radiotherapy:impact of guidelines[J].Int J Radiat Oncol Biol Phys,2006,66(6):372-376. [11] Pitkanen MA,Holli KA,Ojala AT,et al. Quality assurance in radiotherapy of breast cancer-variability in planning target volume delineation[J].Acta Oncol,2001,40(1):50-55. [12] Lobefalo F,Bignardi M,Reggiori G,et al. Dosimetric impact of inter-observer variability for 3D conformal radiotherapy and volumetric modulated arc therapy:the rectal tumor target definition case[J].Radiat Oncol, 2013,8:176.DOI:10.1186/1748-717X-8-176. [13] 王利宁,李建斌,徐敏,等.勾画者及勾画标准对基于4D-CT周围型肺癌靶区勾画的影响[J].中华放射医学与防护杂志,2012,32(5):494-497.DOI:10.3760/cma.j.issn.0254-5098.2012.05.011. Wang LN,Li JB,Xu M,et al. Effect of sketch and sketch criteria on target area mapping based on 4D-CT peripheral lung cancer[J].Chin J Radiol Med Prevent,2012,32(5):494-497.DOI:10.3760/cma.j.issn.0254-5098.2012.05.011. [14] 钱建军,邢鹏飞,陆雪官,等.鼻咽癌IMRT中OAR勾画差异所致剂量不确定性研究[J].中华放射肿瘤学杂志,2014,23(3):239-243.DOI:10.3760/cma.j.issn.1004-4221.2014.03.016. Qian JJ,Xing PF,Lu XG,et al. Study on dose uncertainty caused by difference in oar mapping in nasopharyngeal carcinoma IMRT[J].Chin J Radiat Oncol,2014,23(3):239-243.DOI:10.3760/cma.j.issn.1004-4221.2014.03.016.