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Comparison of investigator-delineated gross tumor volumes and quality assurance in pancreatic cancer: Analysis of the pretrial benchmark case for the SCALOP trial

Comparison of investigator-delineated gross tumor volumes and quality assurance in pancreatic cancer: Analysis of the pretrial benchmark case for the SCALOP trial
Comparison of investigator-delineated gross tumor volumes and quality assurance in pancreatic cancer: Analysis of the pretrial benchmark case for the SCALOP trial
Background and purpose: to evaluate the variation in investigator-delineated volumes and assess plans from the radiotherapy trial quality assurance (RTTQA) program of SCALOP, a phase II trial in locally advanced pancreatic cancer.

Materials and methods: participating investigators (n = 25) outlined a pre-trial benchmark case as per RT protocol, and the accuracy of investigators’ GTV (iGTV) and PTV (iPTV) was evaluated, against the trials team-defined gold standard GTV (gsGTV) and PTV (gsPTV), using both qualitative and geometric analyses. The median Jaccard Conformity Index (JCI) and Geographical Miss Index (GMI) were calculated. Participating RT centers also submitted a radiotherapy plan for this benchmark case, which was centrally reviewed against protocol-defined constraints.

Results: twenty-five investigator-defined contours were evaluated. The median JCI and GMI of iGTVs were 0.57 (IQR: 0.51–0.65) and 0.26 (IQR: 0.15–0.40). For iPTVs, these were 0.75 (IQR: 0.71–0.79) and 0.14 (IQR: 0.11–0.22) respectively. Qualitative analysis showed largest variation at the tumor edges and failure to recognize a peri-pancreatic lymph node. There were no major protocol deviations in RT planning, but three minor PTV coverage deviations were identified.

Conclusions: SCALOP demonstrated considerable variation in iGTV delineation. RTTQA workshops and real-time central review of delineations are needed in future trials.
0167-8140
432-437
Fokas, Emmanouil
b2b3522d-acd5-480b-aacb-a07beaf8033d
Clifford, Charlotte
a239229d-4da9-4d07-9a07-5171596df983
Spezi, Emiliano
2eab7319-0edc-4658-996d-9b00959b9124
Joseph, George
8ee5391b-374f-456c-9a53-80c05107f0e7
Branagan, Jennifer
ed1de4e3-ddbd-4a02-ab4a-4eff0dd94b2d
Hurt, Chris
bf8b37a0-8f08-4b47-b3f3-6fc65f7ab87f
Nixon, Lisette
14cb3daf-d29a-4734-9e18-1b891e8c2fcc
Abrams, Ross
6db24e9a-24bb-4f34-8d32-a97352af4e09
Staffurth, John
db58e06d-eb84-485a-8656-ea5d48ba548e
Mukherjee, Somnath
d9278fe6-ec80-45e0-b3ab-137e668787e8
Fokas, Emmanouil
b2b3522d-acd5-480b-aacb-a07beaf8033d
Clifford, Charlotte
a239229d-4da9-4d07-9a07-5171596df983
Spezi, Emiliano
2eab7319-0edc-4658-996d-9b00959b9124
Joseph, George
8ee5391b-374f-456c-9a53-80c05107f0e7
Branagan, Jennifer
ed1de4e3-ddbd-4a02-ab4a-4eff0dd94b2d
Hurt, Chris
bf8b37a0-8f08-4b47-b3f3-6fc65f7ab87f
Nixon, Lisette
14cb3daf-d29a-4734-9e18-1b891e8c2fcc
Abrams, Ross
6db24e9a-24bb-4f34-8d32-a97352af4e09
Staffurth, John
db58e06d-eb84-485a-8656-ea5d48ba548e
Mukherjee, Somnath
d9278fe6-ec80-45e0-b3ab-137e668787e8

Fokas, Emmanouil, Clifford, Charlotte, Spezi, Emiliano, Joseph, George, Branagan, Jennifer, Hurt, Chris, Nixon, Lisette, Abrams, Ross, Staffurth, John and Mukherjee, Somnath (2015) Comparison of investigator-delineated gross tumor volumes and quality assurance in pancreatic cancer: Analysis of the pretrial benchmark case for the SCALOP trial. Radiotherapy and Oncology, 117 (3), 432-437. (doi:10.1016/j.radonc.2015.08.026).

Record type: Article

Abstract

Background and purpose: to evaluate the variation in investigator-delineated volumes and assess plans from the radiotherapy trial quality assurance (RTTQA) program of SCALOP, a phase II trial in locally advanced pancreatic cancer.

Materials and methods: participating investigators (n = 25) outlined a pre-trial benchmark case as per RT protocol, and the accuracy of investigators’ GTV (iGTV) and PTV (iPTV) was evaluated, against the trials team-defined gold standard GTV (gsGTV) and PTV (gsPTV), using both qualitative and geometric analyses. The median Jaccard Conformity Index (JCI) and Geographical Miss Index (GMI) were calculated. Participating RT centers also submitted a radiotherapy plan for this benchmark case, which was centrally reviewed against protocol-defined constraints.

Results: twenty-five investigator-defined contours were evaluated. The median JCI and GMI of iGTVs were 0.57 (IQR: 0.51–0.65) and 0.26 (IQR: 0.15–0.40). For iPTVs, these were 0.75 (IQR: 0.71–0.79) and 0.14 (IQR: 0.11–0.22) respectively. Qualitative analysis showed largest variation at the tumor edges and failure to recognize a peri-pancreatic lymph node. There were no major protocol deviations in RT planning, but three minor PTV coverage deviations were identified.

Conclusions: SCALOP demonstrated considerable variation in iGTV delineation. RTTQA workshops and real-time central review of delineations are needed in future trials.

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More information

Accepted/In Press date: 19 August 2015
e-pub ahead of print date: 29 August 2015
Published date: 17 December 2015

Identifiers

Local EPrints ID: 488260
URI: http://eprints.soton.ac.uk/id/eprint/488260
ISSN: 0167-8140
PURE UUID: 0477486d-8d42-44fd-8d98-127d7d4dc0ec
ORCID for Chris Hurt: ORCID iD orcid.org/0000-0003-1206-8355

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Date deposited: 19 Mar 2024 17:46
Last modified: 23 Mar 2024 03:13

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Contributors

Author: Emmanouil Fokas
Author: Charlotte Clifford
Author: Emiliano Spezi
Author: George Joseph
Author: Jennifer Branagan
Author: Chris Hurt ORCID iD
Author: Lisette Nixon
Author: Ross Abrams
Author: John Staffurth
Author: Somnath Mukherjee

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