A heart atlas for breast radiation therapy and the influence of delination education on both intra and interobserver variability

Kirli M., AKÇAY D., BARIŞ M. M., Goerken İ.

JAPANESE JOURNAL OF RADIOLOGY, cilt.37, sa.5, ss.420-430, 2019 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 37 Sayı: 5
  • Basım Tarihi: 2019
  • Doi Numarası: 10.1007/s11604-019-00819-1
  • Dergi Adı: JAPANESE JOURNAL OF RADIOLOGY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.420-430
  • Anahtar Kelimeler: Breast radiotherapy, Heart atlas, Cardiac subunit delineation, TERM CARDIAC MORTALITY, 20-YEAR FOLLOW-UP, RANDOMIZED-TRIAL, ADJUVANT RADIOTHERAPY, CONSERVING THERAPY, CONTOURING ATLAS, CANCER, RISK, MASTECTOMY, ASSOCIATION
  • Dokuz Eylül Üniversitesi Adresli: Evet

Özet

PurposeWe developed a heart atlas for breast radiation therapy and evaluated the influence of education on intra and inter-observer similarity, and cardiac dose reporting.Materials and methodsThe data of 16 left breast cancer patients were analyzed. Eight observers delineated heart and cardiac subunits [left (LCA) and right (RCA) coronary arteries, left anterior descending artery (LAD), bilateral atrium and ventricles] before the education. A radiologist and radiation oncologist developed the atlas and delineated the gold standard (GS) volumes. Observers repeated the delineation after education. RT plans were made for pre/post-atlas contours. The similarity was assessed by Dice (DSC) and Jaccard (JSC) similarity coefficient indices. The absolute difference rate was calculated for the dose analysis.ResultsThe inter-observer similarity increased in heart and all subunits. The intra-observer similarity showed a heterogeneous distribution. The absolute difference rate in dose reporting was statistically significant for the bilateral atrium, right ventricle, LAD, LCA+LAD, RCA's maximum doses (p<0.05). The maximum dosereporting differences from the GS decreased from 16.9 to 8.9% for LAD (p=0.011); from 14.8 to 9.3% for LCA+LAD (p=0.010).ConclusionThe cardiac atlas reduces the intra-interobserver differences and improves dosereporting consistency. The first intra-observer similarity analysis was made in our study and revealed the need for repeated education to increase the consistency.