Multiple training interventions significantly improve reproducibility of PET/CT-based lung cancer radiotherapy target volume delineation using an IAEA study protocol

作者：Konert Tom; Vogel Wouter V; Everitt Sarah; MacManus Michael P; Thorwarth Daniela; Fidarova Elena; Paez Diana; Sonke Jan Jakob; Hanna Gerard G^*

来源：Radiotherapy and Oncology, 2016, 121(1): 39-45.

DOI：10.1016/j.radonc.2016.09.002

• Lung cancer
• PET/CT
• Radiation treatment planning
• Radiotherapy
• Target volume delineation
• Training interventions

Background and purpose: To assess the impact of a standardized delineation protocol and training interventions on PET/CT-based target volume delineation (TVD) in NSCLC in a multicenter setting.
Material and methods: Over a one-year period, 11 pairs, comprised each of a radiation oncologist and nuclear medicine physician with limited experience in PET/CT-based TVD for NSCLC from nine different countries took part in a training program through an International Atomic Energy Agency (IAEA) study (NCT02247713). Teams delineated gross tumor volume of the primary tumor, during and after training interventions, according to a provided delineation protocol. In-house developed software recorded the performed delineations, to allow visual inspection of strategies and to assess delineation accuracy.
Results: Following the first training, overall concordance indices for 3 repetitive cases increased from 0.57 +/- 0.07 to 0.66 +/- 0.07. The overall mean surface distance between observer and expert contours decreased from -0.40 +/- 0.03 cm to -0.01 +/- 0.33 cm. After further training overall concordance indices for another 3 repetitive cases further increased from 0.64 +/- 0.06 to 0.80 +/- 0.05 (p = 0.01). Mean surface distances decreased from -0.34 +/- 0.16 cm to -0.05 +/- 0.20 cm (p = 0.01).
Conclusion: Multiple training interventions improve PET/CT-based TVD delineation accuracy in NSCLC and reduce interobserver variation.

• 出版日期2016-10