TY - JOUR
T1 - Influence of experience and qualification on PET-based target volume delineation
T2 - When there is no expert-ask your colleague
AU - Nestle, U.
AU - Doll, C.
AU - Duncker-Rohr, V.
AU - Rücker, G.
AU - Mix, M.
AU - MacManus, M.
AU - De Ruysscher, D.
AU - Vogel, W.
AU - Eriksen, J. G.
AU - Oyen, W.
AU - Grosu, A. L.
AU - Weber, W.
PY - 2014/6
Y1 - 2014/6
N2 - Background and purpose: The integration of positron emission tomography (PET) information for target volume delineation in radiation treatment planning is routine in many centers. In contrast to automatic contouring, research on visual-manual delineation is scarce. The present study investigates the dependency of manual delineation on experience and qualification. Patients and methods: A total of 44 international interdisciplinary observers each defined a [18F]fluorodeoxyglucose (FDG)-PET based gross tumor volume (GTV) using the same PET/CT scan from a patient with lung cancer. The observers were "experts" (E; n∈=∈3), "experienced interdisciplinary pairs" (EP; 9 teams of radiation oncologist (RO) + nuclear medicine physician (NP)), "single field specialists" (SFS; n∈=∈13), and "students" (S; n∈=∈10). Five automatic delineation methods (AM) were also included. Volume sizes and concordance indices within the groups (pCI) and relative to the experts (eCI) were calculated. Results: E (pCI =∈0.67) and EP (pCI =∈0.53) showed a significantly higher agreement within the groups as compared to SFS (pCI =∈0.43, p∈=∈0.03, and p∈=∈0.006). In relation to the experts, EP (eCI =∈0.55) showed better concordance compared to SFS (eCI =∈0.49) or S (eCI =∈0.47). The intermethod variability of the AM (pCI =∈0.44) was similar to that of SFS and S, showing poorer agreement with the experts (eCI =∈0.35). Conclusion: The results suggest that interdisciplinary cooperation could be beneficial for consistent contouring. Joint delineation by a radiation oncologist and a nuclear medicine physician showed remarkable agreement and better concordance with the experts compared to other specialists. The relevant intermethod variability of the automatic algorithms underlines the need for further standardization and optimization in this field.
AB - Background and purpose: The integration of positron emission tomography (PET) information for target volume delineation in radiation treatment planning is routine in many centers. In contrast to automatic contouring, research on visual-manual delineation is scarce. The present study investigates the dependency of manual delineation on experience and qualification. Patients and methods: A total of 44 international interdisciplinary observers each defined a [18F]fluorodeoxyglucose (FDG)-PET based gross tumor volume (GTV) using the same PET/CT scan from a patient with lung cancer. The observers were "experts" (E; n∈=∈3), "experienced interdisciplinary pairs" (EP; 9 teams of radiation oncologist (RO) + nuclear medicine physician (NP)), "single field specialists" (SFS; n∈=∈13), and "students" (S; n∈=∈10). Five automatic delineation methods (AM) were also included. Volume sizes and concordance indices within the groups (pCI) and relative to the experts (eCI) were calculated. Results: E (pCI =∈0.67) and EP (pCI =∈0.53) showed a significantly higher agreement within the groups as compared to SFS (pCI =∈0.43, p∈=∈0.03, and p∈=∈0.006). In relation to the experts, EP (eCI =∈0.55) showed better concordance compared to SFS (eCI =∈0.49) or S (eCI =∈0.47). The intermethod variability of the AM (pCI =∈0.44) was similar to that of SFS and S, showing poorer agreement with the experts (eCI =∈0.35). Conclusion: The results suggest that interdisciplinary cooperation could be beneficial for consistent contouring. Joint delineation by a radiation oncologist and a nuclear medicine physician showed remarkable agreement and better concordance with the experts compared to other specialists. The relevant intermethod variability of the automatic algorithms underlines the need for further standardization and optimization in this field.
KW - 18F-FDG PET
KW - Interobserver variability
KW - Lung cancer
KW - Radiation therapy planning
KW - Visual-manual delineation
UR - http://www.scopus.com/inward/record.url?scp=84901624243&partnerID=8YFLogxK
U2 - 10.1007/s00066-014-0644-y
DO - 10.1007/s00066-014-0644-y
M3 - Article
C2 - 24615189
AN - SCOPUS:84901624243
SN - 0179-7158
VL - 190
SP - 555
EP - 562
JO - Strahlentherapie und Onkologie
JF - Strahlentherapie und Onkologie
IS - 6
ER -
