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Assessment of volume segmentation in radiotherapy of adolescents : a treatment planning study by the Swedish Workgroup for Paediatric Radiotherapy.

Kristensen, Ingrid LU ; Agrup, Måns; Bergström, Per; Engellau, Jacob LU ; Haugen, Hedda; Martinsson, Ulla; Nilsson, Kristina; Taheri-Kadkhoda, Zahra; Lindh, Jack and Nilsson, Per LU (2014) In Acta Oncologica 53(1). p.126-133
Abstract
Background and purpose. The variability in target delineation for similar cases between centres treating paediatric and adolescent patients, and the apparent differences in interpretation of radiotherapy guidelines in the treatment protocols encouraged us to perform a dummy-run study as a part of our quality assurance work. The aim was to identify and quantify differences in the segmentation of target volumes and organs at risk (OARs) and to analyse the treatment plans and dose distributions. Materials and methods. Four patient cases were selected: Wilm's tumour, Hodgkin's disease, rhabdomyosarcoma of the prostate and chordoma of the skull base. The five participating centres received the same patient-related material. They introduced the... (More)
Background and purpose. The variability in target delineation for similar cases between centres treating paediatric and adolescent patients, and the apparent differences in interpretation of radiotherapy guidelines in the treatment protocols encouraged us to perform a dummy-run study as a part of our quality assurance work. The aim was to identify and quantify differences in the segmentation of target volumes and organs at risk (OARs) and to analyse the treatment plans and dose distributions. Materials and methods. Four patient cases were selected: Wilm's tumour, Hodgkin's disease, rhabdomyosarcoma of the prostate and chordoma of the skull base. The five participating centres received the same patient-related material. They introduced the cases in their treatment planning system, delineated target volumes and OARs and created treatment plans. Dose-volume histograms were retrieved for relevant structures and volumes and dose metrics were derived and compared, e.g. target volumes and their concordance, dose homogeneity index (HI), treated and irradiated volumes, remaining volume at risk and relevant Vx and Dx values. Results. We found significant differences in target segmentation in the majority of the cases. The planning target volumes (PTVs) varied two- to four-fold and conformity indices were in the range of 0.3-0.6. This resulted in large variations in dose distributions to OARs as well as in treated and irradiated volumes even though the treatment plans showed good conformity to the PTVs. Potential reasons for the differences in target delineation were analysed. Conclusion. Considerations of the growing child and difficulties in interpretation of the radiotherapy information in the treatment protocols were identified as reasons for the variation. As a result, clarified translated detailed radiotherapy guidelines for paediatric/adolescent patients have been recognised as a way to reduce this variation. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Oncologica
volume
53
issue
1
pages
126 - 133
publisher
Taylor & Francis
external identifiers
  • wos:000328945500018
  • pmid:23577745
  • scopus:84890912348
ISSN
1651-226X
DOI
10.3109/0284186X.2013.782104
language
English
LU publication?
yes
id
d8c6d143-2caa-492c-9d73-400d58bb3ca1 (old id 3733885)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/23577745?dopt=Abstract
date added to LUP
2013-05-04 18:06:29
date last changed
2017-01-09 10:40:02
@article{d8c6d143-2caa-492c-9d73-400d58bb3ca1,
  abstract     = {Background and purpose. The variability in target delineation for similar cases between centres treating paediatric and adolescent patients, and the apparent differences in interpretation of radiotherapy guidelines in the treatment protocols encouraged us to perform a dummy-run study as a part of our quality assurance work. The aim was to identify and quantify differences in the segmentation of target volumes and organs at risk (OARs) and to analyse the treatment plans and dose distributions. Materials and methods. Four patient cases were selected: Wilm's tumour, Hodgkin's disease, rhabdomyosarcoma of the prostate and chordoma of the skull base. The five participating centres received the same patient-related material. They introduced the cases in their treatment planning system, delineated target volumes and OARs and created treatment plans. Dose-volume histograms were retrieved for relevant structures and volumes and dose metrics were derived and compared, e.g. target volumes and their concordance, dose homogeneity index (HI), treated and irradiated volumes, remaining volume at risk and relevant Vx and Dx values. Results. We found significant differences in target segmentation in the majority of the cases. The planning target volumes (PTVs) varied two- to four-fold and conformity indices were in the range of 0.3-0.6. This resulted in large variations in dose distributions to OARs as well as in treated and irradiated volumes even though the treatment plans showed good conformity to the PTVs. Potential reasons for the differences in target delineation were analysed. Conclusion. Considerations of the growing child and difficulties in interpretation of the radiotherapy information in the treatment protocols were identified as reasons for the variation. As a result, clarified translated detailed radiotherapy guidelines for paediatric/adolescent patients have been recognised as a way to reduce this variation.},
  author       = {Kristensen, Ingrid and Agrup, Måns and Bergström, Per and Engellau, Jacob and Haugen, Hedda and Martinsson, Ulla and Nilsson, Kristina and Taheri-Kadkhoda, Zahra and Lindh, Jack and Nilsson, Per},
  issn         = {1651-226X},
  language     = {eng},
  number       = {1},
  pages        = {126--133},
  publisher    = {Taylor & Francis},
  series       = {Acta Oncologica},
  title        = {Assessment of volume segmentation in radiotherapy of adolescents : a treatment planning study by the Swedish Workgroup for Paediatric Radiotherapy.},
  url          = {http://dx.doi.org/10.3109/0284186X.2013.782104},
  volume       = {53},
  year         = {2014},
}