Inter-observer agreement in GTV delineation of bone metastases on CT and impact of MR imaging: A multicenter study

A S Gerlich, J M van der Velden, A N T J Kotte, C L Tseng, G Fanetti, W S C Eppinga, N Kasperts, M P W Intven, F A Pameijer, M E P Philippens, H M Verkooijen, E Seravalli

Research output: Contribution to journalArticle

Abstract

BACKGROUND AND PURPOSE: The use of Stereotactic Body Radiotherapy (SBRT) for bone metastases is increasing rapidly. Therefore, knowledge of the inter-observer differences in tumor volume delineation is essential to guarantee precise dose delivery. The aim of this study is to compare inter-observer agreement in bone metastases delineated on different imaging modalities.

MATERIAL AND METHODS: Twenty consecutive patients with bone metastases treated with SBRT were selected. All patients received CT and MR imaging in treatment position prior to SBRT. Five observers from three institutions independently delineated gross tumor volume (GTV) on CT alone, CT with co-registered MRI and MRI alone. Four contours per imaging modality per patient were available, as one set of contours was shared by 2 observers. Inter-observer agreement, expressed in generalized conformity index [CIgen], volumes of contours and contours center of mass (COM) were calculated per patient and imaging modality.

RESULTS: Mean GTV delineated on MR (45.9±52.0cm3) was significantly larger compared to CT-MR (40.2±49.4cm3) and CT (34.8±41.8cm3). A considerable variation in CIgen was found on CT (mean 0.46, range 0.15-0.75) and CT-MRI (mean 0.54, range 0.17-0.71). The highest agreement was found on MRI (mean 0.56, range 0.20-0.77). The largest variations of COM were found in anterior-posterior direction for all imaging modalities.

CONCLUSIONS: Large inter-observer variation in GTV delineation exists for CT, CT-MRI and MRI. MRI-based GTV delineation resulted in larger volumes and highest consistency between observers.

Original languageEnglish
Pages (from-to)534-540
Number of pages7
JournalRadiotherapy and Oncology
Volume126
Issue number3
DOIs
Publication statusPublished - Mar 2018
Externally publishedYes

Fingerprint

Tumor Burden
Multicenter Studies
Radiosurgery
Neoplasm Metastasis
Bone and Bones
Cone-Beam Computed Tomography
Observer Variation
Therapeutics

Keywords

  • Bone Neoplasms/diagnostic imaging
  • Cohort Studies
  • Humans
  • Magnetic Resonance Imaging/methods
  • Observer Variation
  • Prospective Studies
  • Radiosurgery
  • Radiotherapy Planning, Computer-Assisted/methods
  • Tomography, X-Ray Computed/methods
  • Tumor Burden

Cite this

Gerlich, A. S., van der Velden, J. M., Kotte, A. N. T. J., Tseng, C. L., Fanetti, G., Eppinga, W. S. C., ... Seravalli, E. (2018). Inter-observer agreement in GTV delineation of bone metastases on CT and impact of MR imaging: A multicenter study. Radiotherapy and Oncology, 126(3), 534-540. https://doi.org/10.1016/j.radonc.2017.08.030

Inter-observer agreement in GTV delineation of bone metastases on CT and impact of MR imaging : A multicenter study. / Gerlich, A S; van der Velden, J M; Kotte, A N T J; Tseng, C L; Fanetti, G; Eppinga, W S C; Kasperts, N; Intven, M P W; Pameijer, F A; Philippens, M E P; Verkooijen, H M; Seravalli, E.

In: Radiotherapy and Oncology, Vol. 126, No. 3, 03.2018, p. 534-540.

Research output: Contribution to journalArticle

Gerlich, AS, van der Velden, JM, Kotte, ANTJ, Tseng, CL, Fanetti, G, Eppinga, WSC, Kasperts, N, Intven, MPW, Pameijer, FA, Philippens, MEP, Verkooijen, HM & Seravalli, E 2018, 'Inter-observer agreement in GTV delineation of bone metastases on CT and impact of MR imaging: A multicenter study', Radiotherapy and Oncology, vol. 126, no. 3, pp. 534-540. https://doi.org/10.1016/j.radonc.2017.08.030
Gerlich, A S ; van der Velden, J M ; Kotte, A N T J ; Tseng, C L ; Fanetti, G ; Eppinga, W S C ; Kasperts, N ; Intven, M P W ; Pameijer, F A ; Philippens, M E P ; Verkooijen, H M ; Seravalli, E. / Inter-observer agreement in GTV delineation of bone metastases on CT and impact of MR imaging : A multicenter study. In: Radiotherapy and Oncology. 2018 ; Vol. 126, No. 3. pp. 534-540.
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T1 - Inter-observer agreement in GTV delineation of bone metastases on CT and impact of MR imaging

T2 - A multicenter study

AU - Gerlich, A S

AU - van der Velden, J M

AU - Kotte, A N T J

AU - Tseng, C L

AU - Fanetti, G

AU - Eppinga, W S C

AU - Kasperts, N

AU - Intven, M P W

AU - Pameijer, F A

AU - Philippens, M E P

AU - Verkooijen, H M

AU - Seravalli, E

N1 - Copyright © 2017 Elsevier B.V. All rights reserved.

PY - 2018/3

Y1 - 2018/3

N2 - BACKGROUND AND PURPOSE: The use of Stereotactic Body Radiotherapy (SBRT) for bone metastases is increasing rapidly. Therefore, knowledge of the inter-observer differences in tumor volume delineation is essential to guarantee precise dose delivery. The aim of this study is to compare inter-observer agreement in bone metastases delineated on different imaging modalities.MATERIAL AND METHODS: Twenty consecutive patients with bone metastases treated with SBRT were selected. All patients received CT and MR imaging in treatment position prior to SBRT. Five observers from three institutions independently delineated gross tumor volume (GTV) on CT alone, CT with co-registered MRI and MRI alone. Four contours per imaging modality per patient were available, as one set of contours was shared by 2 observers. Inter-observer agreement, expressed in generalized conformity index [CIgen], volumes of contours and contours center of mass (COM) were calculated per patient and imaging modality.RESULTS: Mean GTV delineated on MR (45.9±52.0cm3) was significantly larger compared to CT-MR (40.2±49.4cm3) and CT (34.8±41.8cm3). A considerable variation in CIgen was found on CT (mean 0.46, range 0.15-0.75) and CT-MRI (mean 0.54, range 0.17-0.71). The highest agreement was found on MRI (mean 0.56, range 0.20-0.77). The largest variations of COM were found in anterior-posterior direction for all imaging modalities.CONCLUSIONS: Large inter-observer variation in GTV delineation exists for CT, CT-MRI and MRI. MRI-based GTV delineation resulted in larger volumes and highest consistency between observers.

AB - BACKGROUND AND PURPOSE: The use of Stereotactic Body Radiotherapy (SBRT) for bone metastases is increasing rapidly. Therefore, knowledge of the inter-observer differences in tumor volume delineation is essential to guarantee precise dose delivery. The aim of this study is to compare inter-observer agreement in bone metastases delineated on different imaging modalities.MATERIAL AND METHODS: Twenty consecutive patients with bone metastases treated with SBRT were selected. All patients received CT and MR imaging in treatment position prior to SBRT. Five observers from three institutions independently delineated gross tumor volume (GTV) on CT alone, CT with co-registered MRI and MRI alone. Four contours per imaging modality per patient were available, as one set of contours was shared by 2 observers. Inter-observer agreement, expressed in generalized conformity index [CIgen], volumes of contours and contours center of mass (COM) were calculated per patient and imaging modality.RESULTS: Mean GTV delineated on MR (45.9±52.0cm3) was significantly larger compared to CT-MR (40.2±49.4cm3) and CT (34.8±41.8cm3). A considerable variation in CIgen was found on CT (mean 0.46, range 0.15-0.75) and CT-MRI (mean 0.54, range 0.17-0.71). The highest agreement was found on MRI (mean 0.56, range 0.20-0.77). The largest variations of COM were found in anterior-posterior direction for all imaging modalities.CONCLUSIONS: Large inter-observer variation in GTV delineation exists for CT, CT-MRI and MRI. MRI-based GTV delineation resulted in larger volumes and highest consistency between observers.

KW - Bone Neoplasms/diagnostic imaging

KW - Cohort Studies

KW - Humans

KW - Magnetic Resonance Imaging/methods

KW - Observer Variation

KW - Prospective Studies

KW - Radiosurgery

KW - Radiotherapy Planning, Computer-Assisted/methods

KW - Tomography, X-Ray Computed/methods

KW - Tumor Burden

U2 - 10.1016/j.radonc.2017.08.030

DO - 10.1016/j.radonc.2017.08.030

M3 - Article

C2 - 28919003

VL - 126

SP - 534

EP - 540

JO - Radiotherapy and Oncology

JF - Radiotherapy and Oncology

SN - 0167-8140

IS - 3

ER -