Please use this identifier to cite or link to this item: http://hdl.handle.net/11434/822
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dc.contributor.authorKing, Bronwyn-
dc.contributor.otherLim, K.-
dc.contributor.otherErickson, Beth-
dc.contributor.otherJurgenliemk-Schulz, I. M.-
dc.contributor.otherGaffney, David-
dc.contributor.otherCreutzberg, C. L.-
dc.contributor.otherViswanathan, Akila-
dc.contributor.otherPortelance, L.-
dc.contributor.otherBeriwal, Susil-
dc.contributor.otherWolfson, Aaron-
dc.contributor.otherBosch, Walter-
dc.contributor.otherDe Los Santos, J.-
dc.contributor.otherYashar, Catheryn-
dc.contributor.otherJhingran, Anuja-
dc.contributor.otherVaria, M.-
dc.contributor.otherEl Naqa, I.-
dc.contributor.otherFyles, Anthony-
dc.date2015-07-
dc.date.accessioned2016-10-12T03:41:09Z-
dc.date.available2016-10-12T03:41:09Z-
dc.date.issued2015-11-
dc.identifier.citationPract Radiat Oncol. 2015 Nov-Dec;5(6):e557-65. doi: 10.1016/j.prro.2015.06.011en_US
dc.identifier.issn1879-8500en_US
dc.identifier.urihttp://hdl.handle.net/11434/822-
dc.description.abstractPURPOSE: The purpose of this study was to assess variability in contouring the gross tumor volume (GTV) and clinical target volume (CTV) of 3 clinical cervix cancer cases by a cohort of international experts in the field in preparation for the development of an online teaching atlas. METHODS AND MATERIALS: Twelve international experts participated. Three clinical scenarios: node positivity (PLN), retroverted uterus (RV), and parametrial invasion (PI) were used. Sagittal and axial magnetic resonance images of the clinical cases were downloaded to participants' treatment planning systems for contouring. The GTV/cervix/uterus/parametria/vagina and nodal CTV were contoured. Contour consensus was assessed for sensitivity/specificity using an expectation maximization algorithm called Simultaneous Truth and Performance Level Estimation and experts' overall agreement was summarized by kappa statistics. RESULTS: Agreement for GTV in the 3 clinical cases was high (Simultaneous Truth and Performance Level Estimation sensitivity, 0.54-0.92; specificity, 0.97-0.98; and kappa measure for PLN, RV, and PI was 0.86, 0.76, and 0.42; P < .0001). Moderate to substantial agreement was seen for nodal CTV (kappa statistics for PLN, RV, and PI was 0.65, 0.58, and 0.62; P < .0001), uterus (kappa for PLN, RV, and PI was 0.45, 0.74, and 0.77; P < .0001), and parametria (kappa for PLN, RV, and PI was 0.49, 0.62, and 0.50; P < .0001). Contouring heterogeneity was greatest for the cervix (kappa measure for PLN, RV, and PI was 0.15, 0.4, and 0.24; P < .0001) and vagina (kappa for PLN, RV, and PI was 0.47, 0.36 and 0.46; P < .0001), reflecting difficulties in determining the interface between GTV and these tissues. CONCLUSION: Kappa statistics of the different CTV components generally demonstrated moderate to substantial agreement among international experts in the field of gynecological radiation therapy. Further planning target volume margins accounting for organ motion and setup errors are a necessary addition to the CTV.en_US
dc.publisherElsevieren_US
dc.subjectGross Tumor Volumeen_US
dc.subjectGTVen_US
dc.subjectClinical Target Volumeen_US
dc.subjectCTVen_US
dc.subjectNode Positivityen_US
dc.subjectPLNen_US
dc.subjectRetroverted Uterusen_US
dc.subjectRVen_US
dc.subjectParametrial Invasionen_US
dc.subjectPIen_US
dc.subjectMagnetic Resonance Imagingen_US
dc.subjectMRIen_US
dc.subjectKappa Statisticsen_US
dc.subjectCervical Canceren_US
dc.subjectSimultaneous Truth and Performance Level Estimationen_US
dc.subjectEpworth Radiation Oncology, Epworth Healthcare, Victoria, Australia.en_US
dc.subjectObstetrics and Gynaecology Clinical Institute, Epworth HealthCare, Victoria, Australia-
dc.titleVariability in clinical target volume delineation for intensity modulated radiation therapy in 3 challenging cervix cancer scenarios.en_US
dc.typeJournal Articleen_US
dc.identifier.doi10.1016/j.prro.2015.06.011en_US
dc.identifier.journaltitlePractical Radiation Oncologyen_US
dc.description.pubmedurihttps://www.ncbi.nlm.nih.gov/pubmed/26432679en_US
dc.description.affiliatesLiverpool Cancer Therapy Centre, Liverpool Hospital, Sydney, NSW, Australia.en_US
dc.description.affiliatesDepartment of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin.en_US
dc.description.affiliatesDepartment of Radiation Oncology, University Medical Center Utrecht, Utrecht, The Netherlands.en_US
dc.description.affiliatesDepartment of Radiation Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah.en_US
dc.description.affiliatesDepartment of Clinical Oncology, Leiden University Medical Center, Leiden, The Netherlands.en_US
dc.description.affiliatesDepartment of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts.en_US
dc.description.affiliatesDepartment of Radiation Oncology, University of Miami Miller School of Medicine, Miami, Florida.en_US
dc.description.affiliatesDepartment of Radiation Oncology, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.en_US
dc.description.affiliatesWashington University School of Medicine, St. Louis, Missouri.en_US
dc.description.affiliatesDepartment of Radiation Oncology, University of Alabama at Birmingham, Birmingham, Alabama.en_US
dc.description.affiliatesDepartment of Radiation Medicine and Applied Sciences, University of California, San Diego, School of Medicine, La Jolla, California.en_US
dc.description.affiliatesDepartment of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina.en_US
dc.description.affiliatesDepartment of Radiation Oncology, McGill University Health Center, Montreal, QC, Canada.en_US
dc.description.affiliatesRadiation Medicine Program, Princess Margaret Hospital/Ontario Cancer Institute, University Health Network, Toronto, ON, Canada.en_US
dc.type.studyortrialCase Series and Case Reportsen_US
dc.type.contenttypeTexten_US
Appears in Collections:Cancer Services
Radiation Oncology
Women's and Children's

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