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Reduction of inter-observer differences in the delineation of the target in spinal metastases SBRT using an automatic contouring dedicated system

BACKGROUND: Approximately one third of cancer patients will develop spinal metastases, that can be associated with back pain, neurological symptoms and deterioration in performance status. Stereotactic radiosurgery (SRS) and stereotactic body radiotherapy (SBRT) have been offered in clinical practic...

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Autores principales: Giaj-Levra, Niccolò, Figlia, Vanessa, Cuccia, Francesco, Mazzola, Rosario, Nicosia, Luca, Ricchetti, Francesco, Rigo, Michele, Attinà, Giorgio, Vitale, Claudio, Sicignano, Gianluisa, De Simone, Antonio, Naccarato, Stefania, Ruggieri, Ruggero, Alongi, Filippo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8502264/
https://www.ncbi.nlm.nih.gov/pubmed/34627313
http://dx.doi.org/10.1186/s13014-021-01924-0
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author Giaj-Levra, Niccolò
Figlia, Vanessa
Cuccia, Francesco
Mazzola, Rosario
Nicosia, Luca
Ricchetti, Francesco
Rigo, Michele
Attinà, Giorgio
Vitale, Claudio
Sicignano, Gianluisa
De Simone, Antonio
Naccarato, Stefania
Ruggieri, Ruggero
Alongi, Filippo
author_facet Giaj-Levra, Niccolò
Figlia, Vanessa
Cuccia, Francesco
Mazzola, Rosario
Nicosia, Luca
Ricchetti, Francesco
Rigo, Michele
Attinà, Giorgio
Vitale, Claudio
Sicignano, Gianluisa
De Simone, Antonio
Naccarato, Stefania
Ruggieri, Ruggero
Alongi, Filippo
author_sort Giaj-Levra, Niccolò
collection PubMed
description BACKGROUND: Approximately one third of cancer patients will develop spinal metastases, that can be associated with back pain, neurological symptoms and deterioration in performance status. Stereotactic radiosurgery (SRS) and stereotactic body radiotherapy (SBRT) have been offered in clinical practice mainly for the management of oligometastatic and oligoprogressive patients, allowing the prescription of high total dose delivered in one or few sessions to small target volumes, minimizing the dose exposure of normal tissues. Due to the high delivered doses and the proximity of critical organs at risk (OAR) such as the spinal cord, the correct definition of the treatment volume becomes even more important in SBRT treatment, thus making it necessary to standardize the method of target definition and contouring, through the adoption of specific guidelines and specific automatic contouring tools. An automatic target contouring system for spine SBRT is useful to reduce inter-observer differences in target definition. In this study, an automatic contouring tool was evaluated. METHODS: Simulation CT scans and MRI data of 20 patients with spinal metastases were evaluated. To evaluate the advantage of the automatic target contouring tool (Elements SmartBrush Spine), which uses the identification of different densities within the target vertebra, we evaluated the agreement of the contours of 20 spinal target (2 cervical, 9 dorsal and 9 lumbar column), outlined by three independent observers using the automatic tool compared to the contours obtained manually, and measured by DICE similarity coefficient. RESULTS: The agreement of GTV contours outlined by independent operators was superior with the use of the automatic contour tool compared to manually outlined contours (mean DICE coefficient 0.75 vs 0.57, p = 0.048). CONCLUSIONS: The dedicated contouring tool allows greater precision and reduction of inter-observer differences in the delineation of the target in SBRT spines. Thus, the evaluated system could be useful in the setting of spinal SBRT to reduce uncertainties of contouring increasing the level of precision on target delivered doses.
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spelling pubmed-85022642021-10-20 Reduction of inter-observer differences in the delineation of the target in spinal metastases SBRT using an automatic contouring dedicated system Giaj-Levra, Niccolò Figlia, Vanessa Cuccia, Francesco Mazzola, Rosario Nicosia, Luca Ricchetti, Francesco Rigo, Michele Attinà, Giorgio Vitale, Claudio Sicignano, Gianluisa De Simone, Antonio Naccarato, Stefania Ruggieri, Ruggero Alongi, Filippo Radiat Oncol Research BACKGROUND: Approximately one third of cancer patients will develop spinal metastases, that can be associated with back pain, neurological symptoms and deterioration in performance status. Stereotactic radiosurgery (SRS) and stereotactic body radiotherapy (SBRT) have been offered in clinical practice mainly for the management of oligometastatic and oligoprogressive patients, allowing the prescription of high total dose delivered in one or few sessions to small target volumes, minimizing the dose exposure of normal tissues. Due to the high delivered doses and the proximity of critical organs at risk (OAR) such as the spinal cord, the correct definition of the treatment volume becomes even more important in SBRT treatment, thus making it necessary to standardize the method of target definition and contouring, through the adoption of specific guidelines and specific automatic contouring tools. An automatic target contouring system for spine SBRT is useful to reduce inter-observer differences in target definition. In this study, an automatic contouring tool was evaluated. METHODS: Simulation CT scans and MRI data of 20 patients with spinal metastases were evaluated. To evaluate the advantage of the automatic target contouring tool (Elements SmartBrush Spine), which uses the identification of different densities within the target vertebra, we evaluated the agreement of the contours of 20 spinal target (2 cervical, 9 dorsal and 9 lumbar column), outlined by three independent observers using the automatic tool compared to the contours obtained manually, and measured by DICE similarity coefficient. RESULTS: The agreement of GTV contours outlined by independent operators was superior with the use of the automatic contour tool compared to manually outlined contours (mean DICE coefficient 0.75 vs 0.57, p = 0.048). CONCLUSIONS: The dedicated contouring tool allows greater precision and reduction of inter-observer differences in the delineation of the target in SBRT spines. Thus, the evaluated system could be useful in the setting of spinal SBRT to reduce uncertainties of contouring increasing the level of precision on target delivered doses. BioMed Central 2021-10-09 /pmc/articles/PMC8502264/ /pubmed/34627313 http://dx.doi.org/10.1186/s13014-021-01924-0 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 Research
Giaj-Levra, Niccolò
Figlia, Vanessa
Cuccia, Francesco
Mazzola, Rosario
Nicosia, Luca
Ricchetti, Francesco
Rigo, Michele
Attinà, Giorgio
Vitale, Claudio
Sicignano, Gianluisa
De Simone, Antonio
Naccarato, Stefania
Ruggieri, Ruggero
Alongi, Filippo
Reduction of inter-observer differences in the delineation of the target in spinal metastases SBRT using an automatic contouring dedicated system
title Reduction of inter-observer differences in the delineation of the target in spinal metastases SBRT using an automatic contouring dedicated system
title_full Reduction of inter-observer differences in the delineation of the target in spinal metastases SBRT using an automatic contouring dedicated system
title_fullStr Reduction of inter-observer differences in the delineation of the target in spinal metastases SBRT using an automatic contouring dedicated system
title_full_unstemmed Reduction of inter-observer differences in the delineation of the target in spinal metastases SBRT using an automatic contouring dedicated system
title_short Reduction of inter-observer differences in the delineation of the target in spinal metastases SBRT using an automatic contouring dedicated system
title_sort reduction of inter-observer differences in the delineation of the target in spinal metastases sbrt using an automatic contouring dedicated system
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8502264/
https://www.ncbi.nlm.nih.gov/pubmed/34627313
http://dx.doi.org/10.1186/s13014-021-01924-0
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