基于不同体位定位CT探讨不同勾画者勾画保乳术后部分乳腺外照射靶区差异

doi:10.3760/cma.j.cn113030-20190803-00303

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Abstract Objective To explore the interobserver variabilities in the delineation of the target volume using simulation three-dimensional computed tomography (3DCT) between the supine and prone positions for external-beam partial breast irradiation (EB-PBI) after breast-conserving surgery (BCS). Methods Twenty-seven breast cancer patients who were scheduled to receive EB-PBI after BCS from July 2016 to April 2017 were enrolled in this study. All patients underwent axial 3DCT simulation scanning in the supine and prone positions during free breathing. Based on two different simulation 3DCT acquired, the gross target volume (TB) formed by using surgical clips and the clinical target volume (CTV) were delineated by five radiologists using specific guidelines. The following parameters including the target volume, coefficient of variations (COV) and matching degree (MD) were calculated to analyze the interobserver variability. Twenty-seven breast cancer patients who were scheduled to receive EB-PBI after BCS from July 2016 to April 2017 were enrolled in this study. Results Whether in the supine or prone position, the interobserver variabilities for TB and CTV were statistically significant (P<0.001,P=0.001,P<0.001,P=0.001). And the intersection of CTV in the prone position was 5.79 cm³ greater than that in the supine position (P=0.011). The interobserver variability of COVCTV in the prone positionwas significantly lower than that in the supine position (P=0.014). And the interobserver variabilities of MDTBTB and MDTBCTV in the prone positionwere statistically greater than those in the supine position, respectively (P<0.001,P= 0.001). Conclusions When delineating the target volume of EB-PBI in the prone position, the interobsever variability can be reduced compared with that in the supine position. Hence, it is more reasonable to carry out EB-PBI in the prone position in free breathing.

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	Yu Ting
	Li Yankang
	Li Fengxiang
	Wang Jinzhi
	Wang Wei
	Xu Min
	Zhang Yingjie
	Li Jianbin

Key words： Breast neoplasms/surgery External-beam partial breast irradiation Supine position Prone position Target area delineation

Received: 03 August 2019

Fund:National Key Research and Development Program (2016YFC0904700);Youth Program of National Natural Science Foundation of China (81703038);Shandong Province Key Research and Development Program (2017GSF18102);Shandong Province Natural Science Foundation (ZR2017PH006)

Corresponding Authors: Li Jianbin, Email:lijianbin@msn.com

Cite this article:

Yu Ting,Li Yankang,Li Fengxiang et al. Interobserver variability in the delineation of the target volume based on supine and prone simulation 3DCT for external-beam partial breast irradiation after breast-conserving surgery[J]. Chinese Journal of Radiation Oncology, 2020, 29(6): 432-436.

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http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.cn113030-20190803-00303 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2020/V29/I6/432

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