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Method of computing direction-dependent margins for the development of consensus contouring guidelines
BACKGROUND: Clinical target volume (CTV) contouring guidelines are frequently developed through studies in which experts contour the CTV for a representative set of cases for a given treatment site and the consensus CTVs are analyzed to generate margin recommendations. Measures of interobserver vari...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8045331/ https://www.ncbi.nlm.nih.gov/pubmed/33849576 http://dx.doi.org/10.1186/s13014-021-01799-1 |
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author | Lawrence, Liam S. P. Chin, Lee C. L. Chan, Rachel W. Nguyen, Timothy K. Sahgal, Arjun Tseng, Chia-Lin Lau, Angus Z. |
author_facet | Lawrence, Liam S. P. Chin, Lee C. L. Chan, Rachel W. Nguyen, Timothy K. Sahgal, Arjun Tseng, Chia-Lin Lau, Angus Z. |
author_sort | Lawrence, Liam S. P. |
collection | PubMed |
description | BACKGROUND: Clinical target volume (CTV) contouring guidelines are frequently developed through studies in which experts contour the CTV for a representative set of cases for a given treatment site and the consensus CTVs are analyzed to generate margin recommendations. Measures of interobserver variability are used to quantify agreement between experts. In cases where an isotropic margin is not appropriate, however, there is no standard method to compute margins in specified directions that represent possible routes of tumor spread. Moreover, interobserver variability metrics are often measures of volume overlap that do not account for the dependence of disagreement on direction. To aid in the development of consensus contouring guidelines, this study demonstrates a novel method of quantifying CTV margins and interobserver variability in clinician-specified directions. METHODS: The proposed algorithm was applied to 11 cases of non-spine bone metastases to compute the consensus CTV margin in each direction of intraosseous and extraosseous disease. The median over all cases for each route of spread yielded the recommended margins. The disagreement between experts on the CTV margin was quantified by computing the median of the coefficients of variation for intraosseous and extraosseous margins. RESULTS: The recommended intraosseous and extraosseous margins were 7.0 mm and 8.0 mm, respectively. The median coefficient of variation quantifying the margin disagreement between experts was 0.59 and 0.48 for intraosseous and extraosseous disease. CONCLUSIONS: The proposed algorithm permits the generation of margin recommendations in relation to adjacent anatomy and quantifies interobserver variability in specified directions. This method can be applied to future consensus CTV contouring studies. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13014-021-01799-1. |
format | Online Article Text |
id | pubmed-8045331 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-80453312021-04-14 Method of computing direction-dependent margins for the development of consensus contouring guidelines Lawrence, Liam S. P. Chin, Lee C. L. Chan, Rachel W. Nguyen, Timothy K. Sahgal, Arjun Tseng, Chia-Lin Lau, Angus Z. Radiat Oncol Methodology BACKGROUND: Clinical target volume (CTV) contouring guidelines are frequently developed through studies in which experts contour the CTV for a representative set of cases for a given treatment site and the consensus CTVs are analyzed to generate margin recommendations. Measures of interobserver variability are used to quantify agreement between experts. In cases where an isotropic margin is not appropriate, however, there is no standard method to compute margins in specified directions that represent possible routes of tumor spread. Moreover, interobserver variability metrics are often measures of volume overlap that do not account for the dependence of disagreement on direction. To aid in the development of consensus contouring guidelines, this study demonstrates a novel method of quantifying CTV margins and interobserver variability in clinician-specified directions. METHODS: The proposed algorithm was applied to 11 cases of non-spine bone metastases to compute the consensus CTV margin in each direction of intraosseous and extraosseous disease. The median over all cases for each route of spread yielded the recommended margins. The disagreement between experts on the CTV margin was quantified by computing the median of the coefficients of variation for intraosseous and extraosseous margins. RESULTS: The recommended intraosseous and extraosseous margins were 7.0 mm and 8.0 mm, respectively. The median coefficient of variation quantifying the margin disagreement between experts was 0.59 and 0.48 for intraosseous and extraosseous disease. CONCLUSIONS: The proposed algorithm permits the generation of margin recommendations in relation to adjacent anatomy and quantifies interobserver variability in specified directions. This method can be applied to future consensus CTV contouring studies. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13014-021-01799-1. BioMed Central 2021-04-13 /pmc/articles/PMC8045331/ /pubmed/33849576 http://dx.doi.org/10.1186/s13014-021-01799-1 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Methodology Lawrence, Liam S. P. Chin, Lee C. L. Chan, Rachel W. Nguyen, Timothy K. Sahgal, Arjun Tseng, Chia-Lin Lau, Angus Z. Method of computing direction-dependent margins for the development of consensus contouring guidelines |
title | Method of computing direction-dependent margins for the development of consensus contouring guidelines |
title_full | Method of computing direction-dependent margins for the development of consensus contouring guidelines |
title_fullStr | Method of computing direction-dependent margins for the development of consensus contouring guidelines |
title_full_unstemmed | Method of computing direction-dependent margins for the development of consensus contouring guidelines |
title_short | Method of computing direction-dependent margins for the development of consensus contouring guidelines |
title_sort | method of computing direction-dependent margins for the development of consensus contouring guidelines |
topic | Methodology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8045331/ https://www.ncbi.nlm.nih.gov/pubmed/33849576 http://dx.doi.org/10.1186/s13014-021-01799-1 |
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