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Interobserver variability in the delineation of the tumour bed using seroma and surgical clips based on 4DCT scan for external-beam partial breast irradiation.

Guo B, Li J, Wang W, Xu M, Shao Q, Zhang Y, Liang C, Guo Y - Radiat Oncol (2015)

Bottom Line: The interobserver variability for TBC and TBC+S and for COVC and COVC+S were statistically significant (p = 0.021, 0.008, 0.002, 0.015).No significant difference was observed for TBS and COVS (p = 0.867, 0.061).Significant differences in interobserver variability were observed for MDC vs MDS, MDC vs MDC+S, MDS vs MDC+S (p = 0.000, 0.032, 0.008), the interobserver variability of MDS was smaller than that of MDC and MDC+S (MDS > MDC+S > MDC).

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Jiyan Road, Jinan, Shandong Province, 250117, China. guobing9541@163.com.

ABSTRACT

Background: To explore the interobserver variability in the delineation of the tumour bed using seroma and surgical clips based on the four-dimensional computed tomography (4DCT) scan for external-beam partial breast irradiation (EB-PBI) during free breathing.

Methods: Patients with a seroma clarity score (SCS) 3 ~ 5 and ≥5 surgical clips in the lumpectomy cavity after breast-conserving surgery who were recruited for EB-PBI underwent 4DCT simulation. Based on the ten sets of 4DCT images acquired, the tumour bed formed using the clips, the seroma, and both the clips and seroma (defined as TBC, TBS and TBC+S, respectively) were delineated by five radiation oncologists using specific guidelines. The following parameters were calculated to analyse interobserver variability: volume of the tumour bed (TBC, TBS, TBC+S), coefficient of variation (COVC, COVS, COVC+S), and matching degree (MDC, MDS, MDC+S).

Results: The interobserver variability for TBC and TBC+S and for COVC and COVC+S were statistically significant (p = 0.021, 0.008, 0.002, 0.015). No significant difference was observed for TBS and COVS (p = 0.867, 0.061). Significant differences in interobserver variability were observed for MDC vs MDS, MDC vs MDC+S, MDS vs MDC+S (p = 0.000, 0.032, 0.008), the interobserver variability of MDS was smaller than that of MDC and MDC+S (MDS > MDC+S > MDC).

Conclusions: When the SCS was 3 ~ 5 points and the number of surgical clips was ≥5, interobserver variability was minimal for the delineation of the tumour bed based on seroma.

No MeSH data available.


Related in: MedlinePlus

Single CT slice and volumetric image of one patient with delineated TBC(a), TBS(b) and TBC+S(c) of all 5 observers. TBC, the TB delineated based on clips; TBS, the TB delineated based on the seroma; TBC+S, the TB delineated based on both seroma and clips.
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Fig1: Single CT slice and volumetric image of one patient with delineated TBC(a), TBS(b) and TBC+S(c) of all 5 observers. TBC, the TB delineated based on clips; TBS, the TB delineated based on the seroma; TBC+S, the TB delineated based on both seroma and clips.

Mentions: The 10% ~ 90% phases of the 4DCT images were registered on the 0% phase images, which served as the basic phase image. The tumour beds were delineated from the ten sets of 4DCT images based on the clips, the seroma, and both the clips and seroma (termed TBC, TBS, TBC+S, respectively) according to a set of guidelines [13] (Figure 1). When the TB was delineated based on clips, we adjusted the window level and width to minimise the impact of seroma for contouring. All observers outlined a single test case that was reviewed prior to commencing the study to ensure that the guidelines were being followed.Figure 1


Interobserver variability in the delineation of the tumour bed using seroma and surgical clips based on 4DCT scan for external-beam partial breast irradiation.

Guo B, Li J, Wang W, Xu M, Shao Q, Zhang Y, Liang C, Guo Y - Radiat Oncol (2015)

Single CT slice and volumetric image of one patient with delineated TBC(a), TBS(b) and TBC+S(c) of all 5 observers. TBC, the TB delineated based on clips; TBS, the TB delineated based on the seroma; TBC+S, the TB delineated based on both seroma and clips.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4363049&req=5

Fig1: Single CT slice and volumetric image of one patient with delineated TBC(a), TBS(b) and TBC+S(c) of all 5 observers. TBC, the TB delineated based on clips; TBS, the TB delineated based on the seroma; TBC+S, the TB delineated based on both seroma and clips.
Mentions: The 10% ~ 90% phases of the 4DCT images were registered on the 0% phase images, which served as the basic phase image. The tumour beds were delineated from the ten sets of 4DCT images based on the clips, the seroma, and both the clips and seroma (termed TBC, TBS, TBC+S, respectively) according to a set of guidelines [13] (Figure 1). When the TB was delineated based on clips, we adjusted the window level and width to minimise the impact of seroma for contouring. All observers outlined a single test case that was reviewed prior to commencing the study to ensure that the guidelines were being followed.Figure 1

Bottom Line: The interobserver variability for TBC and TBC+S and for COVC and COVC+S were statistically significant (p = 0.021, 0.008, 0.002, 0.015).No significant difference was observed for TBS and COVS (p = 0.867, 0.061).Significant differences in interobserver variability were observed for MDC vs MDS, MDC vs MDC+S, MDS vs MDC+S (p = 0.000, 0.032, 0.008), the interobserver variability of MDS was smaller than that of MDC and MDC+S (MDS > MDC+S > MDC).

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Jiyan Road, Jinan, Shandong Province, 250117, China. guobing9541@163.com.

ABSTRACT

Background: To explore the interobserver variability in the delineation of the tumour bed using seroma and surgical clips based on the four-dimensional computed tomography (4DCT) scan for external-beam partial breast irradiation (EB-PBI) during free breathing.

Methods: Patients with a seroma clarity score (SCS) 3 ~ 5 and ≥5 surgical clips in the lumpectomy cavity after breast-conserving surgery who were recruited for EB-PBI underwent 4DCT simulation. Based on the ten sets of 4DCT images acquired, the tumour bed formed using the clips, the seroma, and both the clips and seroma (defined as TBC, TBS and TBC+S, respectively) were delineated by five radiation oncologists using specific guidelines. The following parameters were calculated to analyse interobserver variability: volume of the tumour bed (TBC, TBS, TBC+S), coefficient of variation (COVC, COVS, COVC+S), and matching degree (MDC, MDS, MDC+S).

Results: The interobserver variability for TBC and TBC+S and for COVC and COVC+S were statistically significant (p = 0.021, 0.008, 0.002, 0.015). No significant difference was observed for TBS and COVS (p = 0.867, 0.061). Significant differences in interobserver variability were observed for MDC vs MDS, MDC vs MDC+S, MDS vs MDC+S (p = 0.000, 0.032, 0.008), the interobserver variability of MDS was smaller than that of MDC and MDC+S (MDS > MDC+S > MDC).

Conclusions: When the SCS was 3 ~ 5 points and the number of surgical clips was ≥5, interobserver variability was minimal for the delineation of the tumour bed based on seroma.

No MeSH data available.


Related in: MedlinePlus