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Toward semi-automated assessment of target volume delineation in radiotherapy trials: the SCOPE 1 pretrial test case

Toward semi-automated assessment of target volume delineation in radiotherapy trials: the SCOPE 1 pretrial test case
Toward semi-automated assessment of target volume delineation in radiotherapy trials: the SCOPE 1 pretrial test case

Purpose: to evaluate different conformity indices (CIs) for use in the analysis of outlining consistency within the pretrial quality assurance (Radiotherapy Trials Quality Assurance [RTTQA]) program of a multicenter chemoradiation trial of esophageal cancer and to make recommendations for their use in future trials.

Methods and materials: the National Cancer Research Institute SCOPE 1 trial is an ongoing Cancer Research UK-funded phase II/III randomized controlled trial of chemoradiation with capecitabine and cisplatin with or without cetuximab for esophageal cancer. The pretrial RTTQA program included a detailed radiotherapy protocol, an educational package, and a single mid-esophageal tumor test case that were sent to each investigator to outline. Investigator gross tumor volumes (GTVs) were received from 50 investigators in 34 UK centers, and CERR (Computational Environment for Radiotherapy Research) was used to perform an assessment of each investigator GTV against a predefined gold-standard GTV using different CIs. A new metric, the local conformity index (l-CI), that can localize areas of maximal discordance was developed.

Results: the median Jaccard conformity index (JCI) was 0.69 (interquartile range, 0.62-0.70), with 14 of 50 investigators (28%) achieving a JCI of 0.7 or greater. The median geographical miss index was 0.09 (interquartile range, 0.06-0.16), and the mean discordance index was 0.27 (95% confidence interval, 0.25-0.30). The l-CI was highest in the middle section of the volume, where the tumor was bulky and more easily definable, and identified 4 slices where fewer than 20% of investigators achieved an l-CI of 0.7 or greater.

Conclusions: the available CIs analyze different aspects of a gold standard-observer variation, with JCI being the most useful as a single metric. Additional information is provided by the l-CI and can focus the efforts of the RTTQA team in these areas, possibly leading to semi-automated outlining assessment.

Antibodies, Monoclonal, Antibodies, Monoclonal, Humanized, Antineoplastic Combined Chemotherapy Protocols, Capecitabine, Cetuximab, Chemoradiotherapy, Cisplatin, Deoxycytidine, Esophageal Neoplasms, Fluorouracil, Humans, Observer Variation, Quality Assurance, Health Care, Radiography, Tumor Burden, Clinical Trial, Phase II, Clinical Trial, Phase III, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't
0360-3016
1037-1042
Gwynne, Sarah
0cbce6d8-328d-430e-9f5e-a5885deedac8
Spezi, Emiliano
2eab7319-0edc-4658-996d-9b00959b9124
Wills, Lucy
22aad31b-ce1b-4346-95b2-16e3708e19e2
Hurt, Chris
bf8b37a0-8f08-4b47-b3f3-6fc65f7ab87f
Griffiths, Gareth
7fd300c0-d279-4ff6-842d-aa1f2b9b864d
et al.
Gwynne, Sarah
0cbce6d8-328d-430e-9f5e-a5885deedac8
Spezi, Emiliano
2eab7319-0edc-4658-996d-9b00959b9124
Wills, Lucy
22aad31b-ce1b-4346-95b2-16e3708e19e2
Hurt, Chris
bf8b37a0-8f08-4b47-b3f3-6fc65f7ab87f
Griffiths, Gareth
7fd300c0-d279-4ff6-842d-aa1f2b9b864d

Gwynne, Sarah, Spezi, Emiliano and Wills, Lucy , et al. (2012) Toward semi-automated assessment of target volume delineation in radiotherapy trials: the SCOPE 1 pretrial test case. International Journal of Radiation: Oncology, Biology, Physics, 84 (4), 1037-1042. (doi:10.1016/j.ijrobp.2012.01.094).

Record type: Article

Abstract

Purpose: to evaluate different conformity indices (CIs) for use in the analysis of outlining consistency within the pretrial quality assurance (Radiotherapy Trials Quality Assurance [RTTQA]) program of a multicenter chemoradiation trial of esophageal cancer and to make recommendations for their use in future trials.

Methods and materials: the National Cancer Research Institute SCOPE 1 trial is an ongoing Cancer Research UK-funded phase II/III randomized controlled trial of chemoradiation with capecitabine and cisplatin with or without cetuximab for esophageal cancer. The pretrial RTTQA program included a detailed radiotherapy protocol, an educational package, and a single mid-esophageal tumor test case that were sent to each investigator to outline. Investigator gross tumor volumes (GTVs) were received from 50 investigators in 34 UK centers, and CERR (Computational Environment for Radiotherapy Research) was used to perform an assessment of each investigator GTV against a predefined gold-standard GTV using different CIs. A new metric, the local conformity index (l-CI), that can localize areas of maximal discordance was developed.

Results: the median Jaccard conformity index (JCI) was 0.69 (interquartile range, 0.62-0.70), with 14 of 50 investigators (28%) achieving a JCI of 0.7 or greater. The median geographical miss index was 0.09 (interquartile range, 0.06-0.16), and the mean discordance index was 0.27 (95% confidence interval, 0.25-0.30). The l-CI was highest in the middle section of the volume, where the tumor was bulky and more easily definable, and identified 4 slices where fewer than 20% of investigators achieved an l-CI of 0.7 or greater.

Conclusions: the available CIs analyze different aspects of a gold standard-observer variation, with JCI being the most useful as a single metric. Additional information is provided by the l-CI and can focus the efforts of the RTTQA team in these areas, possibly leading to semi-automated outlining assessment.

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More information

Accepted/In Press date: 31 January 2012
e-pub ahead of print date: 8 August 2012
Published date: 15 November 2012
Keywords: Antibodies, Monoclonal, Antibodies, Monoclonal, Humanized, Antineoplastic Combined Chemotherapy Protocols, Capecitabine, Cetuximab, Chemoradiotherapy, Cisplatin, Deoxycytidine, Esophageal Neoplasms, Fluorouracil, Humans, Observer Variation, Quality Assurance, Health Care, Radiography, Tumor Burden, Clinical Trial, Phase II, Clinical Trial, Phase III, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't
Organisations: Clinical Trials Unit

Identifiers

Local EPrints ID: 406309
URI: http://eprints.soton.ac.uk/id/eprint/406309
ISSN: 0360-3016
PURE UUID: bcb0afe6-e643-4c6e-b97b-7d3967ea99cc
ORCID for Chris Hurt: ORCID iD orcid.org/0000-0003-1206-8355
ORCID for Gareth Griffiths: ORCID iD orcid.org/0000-0002-9579-8021

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Date deposited: 10 Mar 2017 10:44
Last modified: 18 Mar 2024 04:16

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Contributors

Author: Sarah Gwynne
Author: Emiliano Spezi
Author: Lucy Wills
Author: Chris Hurt ORCID iD
Corporate Author: et al.

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