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Uncertainties in target volume delineation in radiotherapy – are they relevant and what can we do about them?

Barbara Segedin
Barbara Segedin
 and 
Primoz Petric
Primoz Petric
   | May 09, 2016
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Article Category: Research Article
Published Online: May 09, 2016
Page range: 254 - 262
Received: Dec 29, 2015
Accepted: Feb 01, 2016
DOI: https://doi.org/10.1515/raon-2016-0023
Keywords
© 2016 Radiol Oncol
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Figure 1

MR images showing interobserver variability between an unexperienced RO and the reference contour in IGABT of 4 cervix cancer patients (from a workshop for RO residents at the Institute of Oncology Ljubljana).
MR images showing interobserver variability between an unexperienced RO and the reference contour in IGABT of 4 cervix cancer patients (from a workshop for RO residents at the Institute of Oncology Ljubljana).

Figure 2

Interobserver variability in delineation of the prostate. MR and CT images in different planes of the same patient are shown. Ability to discriminate prostate apex, base and lateral borders is superior on MRI.cor = coronal; sag = sagittal; tra = transverse40
Interobserver variability in delineation of the prostate. MR and CT images in different planes of the same patient are shown. Ability to discriminate prostate apex, base and lateral borders is superior on MRI.cor = coronal; sag = sagittal; tra = transverse40

Interobserver variation for various tumour sites

TumoursiteTarget volumeNo of ptsNo of obsImaging modalityResultsAuthor (publication date)
  RectumGTV, CTV210CT, PETCTCI(GTV) = 0.26-0.33CI(CTV) = 0.29-0.35Krengli et al 2010
    GTV525CT, PETCT, MRICI = 0.79-0.93Bujisen et al 2012
    CTV810CTCI = 0.63-0.66Nijkamp et al 2012
    GTV64CT, PETCTSI(GTV-P) = 0.77-0.81SI(GTV-N) = 0.22-0.70Patel et al 2007
  StomachCTV, PTV110CTVmax/Vmin(CTV) = 3.4Vmax/Vmin(PTV) = 2.6Jansen et al 2010
  OesophagusGTV150CTJCI = 0.69Gwynne et al 2012
    GTV, CTV, PTV148CTVmax/Vmin(PTV) = 5.25-6.03Tai et al 1998
  Cervix EBRTCTV37CTCI = 0.11-0.57Vmax/Vmin = 3.6-4.9Weiss et al 2003
IGABTGTV, HRCTV, IRCTV610MRICI(GTV) = 0.6-0.8 CI(HR&IRCTV) = 0.6-0.7Petrič et al 2012, 2013
  Head and neckGTV, CTV, PTV120CTVmax/Vmin(CTV) = 18.3Hong et al 2012
GTV413CT, PETCT, MRICI(GTV-P) = 0.54-0.62CI(GTV-N)>0.75Thiagajaran et al 2012
    CTV, CTVE1010CT, MRIlocalSD(CTV) = 3.3-4.4mmlocalSD(CTVe) = 4.9-5.9mmRasch et al 2012
  LungGTV128CT, CBCTCI = 0.27-0.39 CIgen = 0.58-0.70Altorjai et al 2012
    GTV85CTVmax/Vmin>7Van De Steene et al 2002
    GTV1017CTVmax/Vmin = 5.2 CI = 0.04-0.48Giraud et al 2002
    GTV2211CT, PETCTmeanCI = 0.17(CT),0.29(PETCT)localSD = 1cm(CT),0.4cm(PETCT)Steenbakers et al 2006
    GTV192CT, PETCTmedianCI(CT) = 0.61,medianCI(PETCT) = 0.70Fox et al 2005
  BrainCTV75CT + MRICI = 0.14-0.47Cattaneo et al 2005
    GTV59CT, MRIVmax/Vmin(CT) = 1.7-2.8Vmax/Vmin(MR) = 1.5-2.7Weltens et al 2001
  ProstateProstate, seminal vesicles (SV)107CTVmax/Vmin(P) = 1.18-1.63Vmax/Vmin(SV) = 2.02-6.43Valicenti et al 1999
    Prostate32CTVmax/Vmin = 1.39-1.65Seddon et al 2000
    Prostate55CT, MRIMeanCI(MR)CI = 0.83MeanCI(CT) = 0.69Segedin et al 2011
  BreastLumpectomy cavity (LC), CTV153CT, MRICI(LC) = 0.32(MR),0.52(CT)CI(CTV) = 0.77(CT),0.79(MR)Giezen et al 2011,2012
    Lumpectomy cavitiy305CTMeanCI = 0.36Boersma et al 2012
    Lumpectomy cavity, CTV, PTV813CTCI(LC) = 0.19-0.77CI(CTV) = 0.38-0.80CI(PTV) = 0.45-0.81VanMourik et al 2010
    Lumpectomy cavity, PTV9 55 4CTCI(LC) = 0.48-0.52CI(PTV) = 0.55-0.59Vmax/Vmin = 2.2-2.8Major et al 2015
    Lumpectomy cavity, CTV185CTMeanCI(LC) = 0.56MeanCI(CTV) = 0.87Struikmans et al 2005
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