Retroperitoneal Sarcoma Target Volume and Organ at Risk Contour Delineation Agreement among NRG Sarcoma Radiation Oncologists

Elizabeth H. Baldini, Ross A. Abrams, Walter Bosch, David Roberge, Rick L M Haas, Charles N. Catton, Daniel J. Indelicato, Jeffrey R. Olsen, Curtiland Deville, Yen Lin Chen, Steven E. Finkelstein, Thomas F. Delaney, Dian Wang

Research output: Contribution to journalArticle

Abstract

Purpose The purpose of this study was to evaluate the variability in target volume and organ at risk (OAR) contour delineation for retroperitoneal sarcoma (RPS) among 12 sarcoma radiation oncologists. Methods and Materials Radiation planning computed tomography (CT) scans for 2 cases of RPS were distributed among 12 sarcoma radiation oncologists with instructions for contouring gross tumor volume (GTV), clinical target volume (CTV), high-risk CTV (HR CTV: area judged to be at high risk of resulting in positive margins after resection), and OARs: bowel bag, small bowel, colon, stomach, and duodenum. Analysis of contour agreement was performed using the simultaneous truth and performance level estimation (STAPLE) algorithm and kappa statistics. Results Ten radiation oncologists contoured both RPS cases, 1 contoured only RPS1, and 1 contoured only RPS2 such that each case was contoured by 11 radiation oncologists. The first case (RPS 1) was a patient with a de-differentiated (DD) liposarcoma (LPS) with a predominant well-differentiated (WD) component, and the second case (RPS 2) was a patient with DD LPS made up almost entirely of a DD component. Contouring agreement for GTV and CTV contours was high. However, the agreement for HR CTVs was only moderate. For OARs, agreement for stomach, bowel bag, small bowel, and colon was high, but agreement for duodenum (distorted by tumor in one of these cases) was fair to moderate. Conclusions For preoperative treatment of RPS, sarcoma radiation oncologists contoured GTV, CTV, and most OARs with a high level of agreement. HR CTV contours were more variable. Further clarification of this volume with the help of sarcoma surgical oncologists is necessary to reach consensus. More attention to delineation of the duodenum is also needed.

Original languageEnglish (US)
Pages (from-to)1053-1059
Number of pages7
JournalInternational Journal of Radiation Oncology, Biology, Physics
Volume92
Issue number5
DOIs
StatePublished - Aug 1 2015
Externally publishedYes

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Organs at Risk
delineation
organs
Sarcoma
cancer
radiation
Tumor Burden
Duodenum
tumors
Liposarcoma
stomach
bags
Stomach
Colon
Radiation Oncologists
planning
margins
Tomography
education
Radiation

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation
  • Cancer Research

Cite this

Retroperitoneal Sarcoma Target Volume and Organ at Risk Contour Delineation Agreement among NRG Sarcoma Radiation Oncologists. / Baldini, Elizabeth H.; Abrams, Ross A.; Bosch, Walter; Roberge, David; Haas, Rick L M; Catton, Charles N.; Indelicato, Daniel J.; Olsen, Jeffrey R.; Deville, Curtiland; Chen, Yen Lin; Finkelstein, Steven E.; Delaney, Thomas F.; Wang, Dian.

In: International Journal of Radiation Oncology, Biology, Physics, Vol. 92, No. 5, 01.08.2015, p. 1053-1059.

Research output: Contribution to journalArticle

Baldini, EH, Abrams, RA, Bosch, W, Roberge, D, Haas, RLM, Catton, CN, Indelicato, DJ, Olsen, JR, Deville, C, Chen, YL, Finkelstein, SE, Delaney, TF & Wang, D 2015, 'Retroperitoneal Sarcoma Target Volume and Organ at Risk Contour Delineation Agreement among NRG Sarcoma Radiation Oncologists', International Journal of Radiation Oncology, Biology, Physics, vol. 92, no. 5, pp. 1053-1059. https://doi.org/10.1016/j.ijrobp.2015.04.039
Baldini, Elizabeth H. ; Abrams, Ross A. ; Bosch, Walter ; Roberge, David ; Haas, Rick L M ; Catton, Charles N. ; Indelicato, Daniel J. ; Olsen, Jeffrey R. ; Deville, Curtiland ; Chen, Yen Lin ; Finkelstein, Steven E. ; Delaney, Thomas F. ; Wang, Dian. / Retroperitoneal Sarcoma Target Volume and Organ at Risk Contour Delineation Agreement among NRG Sarcoma Radiation Oncologists. In: International Journal of Radiation Oncology, Biology, Physics. 2015 ; Vol. 92, No. 5. pp. 1053-1059.
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abstract = "Purpose The purpose of this study was to evaluate the variability in target volume and organ at risk (OAR) contour delineation for retroperitoneal sarcoma (RPS) among 12 sarcoma radiation oncologists. Methods and Materials Radiation planning computed tomography (CT) scans for 2 cases of RPS were distributed among 12 sarcoma radiation oncologists with instructions for contouring gross tumor volume (GTV), clinical target volume (CTV), high-risk CTV (HR CTV: area judged to be at high risk of resulting in positive margins after resection), and OARs: bowel bag, small bowel, colon, stomach, and duodenum. Analysis of contour agreement was performed using the simultaneous truth and performance level estimation (STAPLE) algorithm and kappa statistics. Results Ten radiation oncologists contoured both RPS cases, 1 contoured only RPS1, and 1 contoured only RPS2 such that each case was contoured by 11 radiation oncologists. The first case (RPS 1) was a patient with a de-differentiated (DD) liposarcoma (LPS) with a predominant well-differentiated (WD) component, and the second case (RPS 2) was a patient with DD LPS made up almost entirely of a DD component. Contouring agreement for GTV and CTV contours was high. However, the agreement for HR CTVs was only moderate. For OARs, agreement for stomach, bowel bag, small bowel, and colon was high, but agreement for duodenum (distorted by tumor in one of these cases) was fair to moderate. Conclusions For preoperative treatment of RPS, sarcoma radiation oncologists contoured GTV, CTV, and most OARs with a high level of agreement. HR CTV contours were more variable. Further clarification of this volume with the help of sarcoma surgical oncologists is necessary to reach consensus. More attention to delineation of the duodenum is also needed.",
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T1 - Retroperitoneal Sarcoma Target Volume and Organ at Risk Contour Delineation Agreement among NRG Sarcoma Radiation Oncologists

AU - Baldini, Elizabeth H.

AU - Abrams, Ross A.

AU - Bosch, Walter

AU - Roberge, David

AU - Haas, Rick L M

AU - Catton, Charles N.

AU - Indelicato, Daniel J.

AU - Olsen, Jeffrey R.

AU - Deville, Curtiland

AU - Chen, Yen Lin

AU - Finkelstein, Steven E.

AU - Delaney, Thomas F.

AU - Wang, Dian

PY - 2015/8/1

Y1 - 2015/8/1

N2 - Purpose The purpose of this study was to evaluate the variability in target volume and organ at risk (OAR) contour delineation for retroperitoneal sarcoma (RPS) among 12 sarcoma radiation oncologists. Methods and Materials Radiation planning computed tomography (CT) scans for 2 cases of RPS were distributed among 12 sarcoma radiation oncologists with instructions for contouring gross tumor volume (GTV), clinical target volume (CTV), high-risk CTV (HR CTV: area judged to be at high risk of resulting in positive margins after resection), and OARs: bowel bag, small bowel, colon, stomach, and duodenum. Analysis of contour agreement was performed using the simultaneous truth and performance level estimation (STAPLE) algorithm and kappa statistics. Results Ten radiation oncologists contoured both RPS cases, 1 contoured only RPS1, and 1 contoured only RPS2 such that each case was contoured by 11 radiation oncologists. The first case (RPS 1) was a patient with a de-differentiated (DD) liposarcoma (LPS) with a predominant well-differentiated (WD) component, and the second case (RPS 2) was a patient with DD LPS made up almost entirely of a DD component. Contouring agreement for GTV and CTV contours was high. However, the agreement for HR CTVs was only moderate. For OARs, agreement for stomach, bowel bag, small bowel, and colon was high, but agreement for duodenum (distorted by tumor in one of these cases) was fair to moderate. Conclusions For preoperative treatment of RPS, sarcoma radiation oncologists contoured GTV, CTV, and most OARs with a high level of agreement. HR CTV contours were more variable. Further clarification of this volume with the help of sarcoma surgical oncologists is necessary to reach consensus. More attention to delineation of the duodenum is also needed.

AB - Purpose The purpose of this study was to evaluate the variability in target volume and organ at risk (OAR) contour delineation for retroperitoneal sarcoma (RPS) among 12 sarcoma radiation oncologists. Methods and Materials Radiation planning computed tomography (CT) scans for 2 cases of RPS were distributed among 12 sarcoma radiation oncologists with instructions for contouring gross tumor volume (GTV), clinical target volume (CTV), high-risk CTV (HR CTV: area judged to be at high risk of resulting in positive margins after resection), and OARs: bowel bag, small bowel, colon, stomach, and duodenum. Analysis of contour agreement was performed using the simultaneous truth and performance level estimation (STAPLE) algorithm and kappa statistics. Results Ten radiation oncologists contoured both RPS cases, 1 contoured only RPS1, and 1 contoured only RPS2 such that each case was contoured by 11 radiation oncologists. The first case (RPS 1) was a patient with a de-differentiated (DD) liposarcoma (LPS) with a predominant well-differentiated (WD) component, and the second case (RPS 2) was a patient with DD LPS made up almost entirely of a DD component. Contouring agreement for GTV and CTV contours was high. However, the agreement for HR CTVs was only moderate. For OARs, agreement for stomach, bowel bag, small bowel, and colon was high, but agreement for duodenum (distorted by tumor in one of these cases) was fair to moderate. Conclusions For preoperative treatment of RPS, sarcoma radiation oncologists contoured GTV, CTV, and most OARs with a high level of agreement. HR CTV contours were more variable. Further clarification of this volume with the help of sarcoma surgical oncologists is necessary to reach consensus. More attention to delineation of the duodenum is also needed.

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