International Multi-institutional Patterns of Contouring Practice and Clinical Target Volume Recommendations for Stereotactic Body Radiation Therapy for Non-Spine Bone Metastases
| Autor: | Wietse Eppinga, Timothy K. Nguyen, Rachel W. Chan, Lee Chin, Arjun Sahgal, Chia-Lin Tseng, Simon S. Lo, Liam S. P. Lawrence, Matthias Guckenberger, Bradley J. Stish, Roi Dagan, Shankar Siva, Angus Z. Lau, Kristin J. Redmond, Jin Ho Kim |
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| Přispěvatelé: | University of Zurich, Tseng, Chia-Lin |
| Rok vydání: | 2022 |
| Předmět: |
Cancer Research
medicine.medical_specialty Stereotactic body radiation therapy Planning target volume 610 Medicine & health Radiosurgery Cohen's kappa medicine 2741 Radiology Nuclear Medicine and Imaging Humans 1306 Cancer Research Radiology Nuclear Medicine and imaging Prospective Studies Contouring Radiation medicine.diagnostic_test business.industry Radiotherapy Planning Computer-Assisted Soft tissue Magnetic resonance imaging 10044 Clinic for Radiation Oncology Magnetic Resonance Imaging Spine Tumor Burden 3108 Radiation medicine.anatomical_structure Oncology 2730 Oncology Cortical bone Radiology business Kappa |
| Zdroj: | International Journal of Radiation Oncology*Biology*Physics. 112:351-360 |
| ISSN: | 0360-3016 |
| DOI: | 10.1016/j.ijrobp.2021.09.004 |
| Popis: | Purpose Despite the increasing use of stereotactic body radiation therapy for non–spine bone metastases (NSBM), there is no established standard for target delineation. The objective of this study was to provide consensus recommendations on clinical target volume (CTV) delineation based on international expert contours. Methods and Materials Eleven cases of NSBM were contoured by 9 international radiation oncologists. For each case, the gross tumor volume was provided on the simulation computed tomography scans with accompanying magnetic resonance imaging. Participants contoured the CTV and completed a clinical survey. Agreement between CTV contours were analyzed with simultaneous truth and performance level estimation using the kappa coefficient and the Dice similarity coefficient (DSC) and summarized to establish contouring recommendations. A direction-dependent analysis was applied to the consensus contours to quantify margins. Results All CTV contours were completed. Six participants used a single-dose level, whereas 3 used a 2-dose level simultaneous integrated boost (SIB) technique. For the SIB cases, the largest volume receiving a stereotactic body radiation therapy (SBRT) dose was used for contour analysis. There was substantial agreement between contours across cases with a mean kappa of 0.72 (mean sensitivity 0.85, mean specificity 0.97). The mean DSC value was 0.77 (range, 0.67-0.87). Consensus CTV contouring recommendations were (1) an intraosseous CTV margin of 5 to 10 mm should be strongly considered within contiguous bone; (2) an extraosseous margin of 5 to 10 mm should be strongly considered where there is soft tissue disease or cortical bone disruption; (3) CTVs should be manually cropped to respect anatomic barriers to spread (eg, peritoneal cavity, pleura, uninvolved joint space and cortical bone). Conclusions CTV contouring recommendations for NSBM-SBRT were established based on analysis of international expert consensus contours with a high level of agreement. These principles may provide guidance to treating physicians and inform future study until prospective clinical data can provide further refinement. |
| Databáze: | OpenAIRE |
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