Variation in the gross tumor volume and clinical target volume for preoperative radiotherapy of primary large high-grade soft tissue sarcoma of the extremity among RTOG sarcoma radiation oncologists

Dian Wang, Walter Bosch, David G. Kirsch, Rawan Al Lozi, Issam El Naqa, David Roberge, Steven E. Finkelstein, Ivy Petersen, Michael Haddock, Yen Lin E Chen, Naoyuki G. Saito, Ying J. Hitchcock, Aaron Wolfson, Thomas F. Delaney

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Purpose: To evaluate variability in the definition of preoperative radiotherapy gross tumor volume (GTV) and clinical target volume (CTV) delineated by sarcoma radiation oncologists. Methods and Materials: Extremity sarcoma planning CT images along with the corresponding diagnostic MRI from two patients were distributed to 10 Radiation Therapy Oncology Group sarcoma radiation oncologists with instructions to define GTV and CTV using standardized guidelines. The CT data with contours were then returned for central analysis. Contours representing statistically corrected 95% (V95) and 100% (V100) agreement were computed for each structure. Results: For the GTV, the minimum, maximum, mean (SD) volumes (mL) were 674, 798, 752 ± 35 for the lower extremity case and 383, 543, 447 ± 46 for the upper extremity case. The volume (cc) of the union, V95 and V100 were 882, 761, and 752 for the lower, and 587, 461, and 455 for the upper extremity, respectively. The overall GTV agreement was judged to be almost perfect in both lower and upper extremity cases (kappa = 0.9 [p < 0.0001] and kappa = 0.86 [p < 0.0001]). For the CTV, the minimum, maximum, mean (SD) volumes (mL) were 1145, 1911, 1605 ± 211 for the lower extremity case and 637, 1246, 1006 ± 180 for the upper extremity case. The volume (cc) of the union, V95, and V100 were 2094, 1609, and 1593 for the lower, and 1533, 1020, and 965 for the upper extremity cases, respectively. The overall CTV agreement was judged to be almost perfect in the lower extremity case (kappa = 0.85 [p < 0.0001]) but only substantial in the upper extremity case (kappa = 0.77 [p < 0.0001]). Conclusions: Almost perfect agreement existed in the GTV of these two representative cases. Tshere was no significant disagreement in the CTV of the lower extremity, but variation in the CTV of upper extremity was seen, perhaps related to the positional differences between the planning CT and the diagnostic MRI.

Original languageEnglish
JournalInternational Journal of Radiation Oncology Biology Physics
Volume81
Issue number5
DOIs
StatePublished - Dec 1 2011

Fingerprint

Tumor Burden
Upper Extremity
Sarcoma
radiation therapy
grade
Radiotherapy
tumors
Extremities
cancer
Lower Extremity
radiation
Radiation Oncology
unions
Radiation Oncologists
Guidelines
planning
education

Keywords

  • Radiotherapy
  • Sarcoma
  • Target definition

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation
  • Cancer Research

Cite this

Variation in the gross tumor volume and clinical target volume for preoperative radiotherapy of primary large high-grade soft tissue sarcoma of the extremity among RTOG sarcoma radiation oncologists. / Wang, Dian; Bosch, Walter; Kirsch, David G.; Al Lozi, Rawan; El Naqa, Issam; Roberge, David; Finkelstein, Steven E.; Petersen, Ivy; Haddock, Michael; Chen, Yen Lin E; Saito, Naoyuki G.; Hitchcock, Ying J.; Wolfson, Aaron; Delaney, Thomas F.

In: International Journal of Radiation Oncology Biology Physics, Vol. 81, No. 5, 01.12.2011.

Research output: Contribution to journalArticle

Wang, Dian ; Bosch, Walter ; Kirsch, David G. ; Al Lozi, Rawan ; El Naqa, Issam ; Roberge, David ; Finkelstein, Steven E. ; Petersen, Ivy ; Haddock, Michael ; Chen, Yen Lin E ; Saito, Naoyuki G. ; Hitchcock, Ying J. ; Wolfson, Aaron ; Delaney, Thomas F. / Variation in the gross tumor volume and clinical target volume for preoperative radiotherapy of primary large high-grade soft tissue sarcoma of the extremity among RTOG sarcoma radiation oncologists. In: International Journal of Radiation Oncology Biology Physics. 2011 ; Vol. 81, No. 5.
@article{329a8400d52549ad8c73be9b90649d0c,
title = "Variation in the gross tumor volume and clinical target volume for preoperative radiotherapy of primary large high-grade soft tissue sarcoma of the extremity among RTOG sarcoma radiation oncologists",
abstract = "Purpose: To evaluate variability in the definition of preoperative radiotherapy gross tumor volume (GTV) and clinical target volume (CTV) delineated by sarcoma radiation oncologists. Methods and Materials: Extremity sarcoma planning CT images along with the corresponding diagnostic MRI from two patients were distributed to 10 Radiation Therapy Oncology Group sarcoma radiation oncologists with instructions to define GTV and CTV using standardized guidelines. The CT data with contours were then returned for central analysis. Contours representing statistically corrected 95{\%} (V95) and 100{\%} (V100) agreement were computed for each structure. Results: For the GTV, the minimum, maximum, mean (SD) volumes (mL) were 674, 798, 752 ± 35 for the lower extremity case and 383, 543, 447 ± 46 for the upper extremity case. The volume (cc) of the union, V95 and V100 were 882, 761, and 752 for the lower, and 587, 461, and 455 for the upper extremity, respectively. The overall GTV agreement was judged to be almost perfect in both lower and upper extremity cases (kappa = 0.9 [p < 0.0001] and kappa = 0.86 [p < 0.0001]). For the CTV, the minimum, maximum, mean (SD) volumes (mL) were 1145, 1911, 1605 ± 211 for the lower extremity case and 637, 1246, 1006 ± 180 for the upper extremity case. The volume (cc) of the union, V95, and V100 were 2094, 1609, and 1593 for the lower, and 1533, 1020, and 965 for the upper extremity cases, respectively. The overall CTV agreement was judged to be almost perfect in the lower extremity case (kappa = 0.85 [p < 0.0001]) but only substantial in the upper extremity case (kappa = 0.77 [p < 0.0001]). Conclusions: Almost perfect agreement existed in the GTV of these two representative cases. Tshere was no significant disagreement in the CTV of the lower extremity, but variation in the CTV of upper extremity was seen, perhaps related to the positional differences between the planning CT and the diagnostic MRI.",
keywords = "Radiotherapy, Sarcoma, Target definition",
author = "Dian Wang and Walter Bosch and Kirsch, {David G.} and {Al Lozi}, Rawan and {El Naqa}, Issam and David Roberge and Finkelstein, {Steven E.} and Ivy Petersen and Michael Haddock and Chen, {Yen Lin E} and Saito, {Naoyuki G.} and Hitchcock, {Ying J.} and Aaron Wolfson and Delaney, {Thomas F.}",
year = "2011",
month = "12",
day = "1",
doi = "10.1016/j.ijrobp.2010.11.033",
language = "English",
volume = "81",
journal = "International Journal of Radiation Oncology Biology Physics",
issn = "0360-3016",
publisher = "Elsevier Inc.",
number = "5",

}

TY - JOUR

T1 - Variation in the gross tumor volume and clinical target volume for preoperative radiotherapy of primary large high-grade soft tissue sarcoma of the extremity among RTOG sarcoma radiation oncologists

AU - Wang, Dian

AU - Bosch, Walter

AU - Kirsch, David G.

AU - Al Lozi, Rawan

AU - El Naqa, Issam

AU - Roberge, David

AU - Finkelstein, Steven E.

AU - Petersen, Ivy

AU - Haddock, Michael

AU - Chen, Yen Lin E

AU - Saito, Naoyuki G.

AU - Hitchcock, Ying J.

AU - Wolfson, Aaron

AU - Delaney, Thomas F.

PY - 2011/12/1

Y1 - 2011/12/1

N2 - Purpose: To evaluate variability in the definition of preoperative radiotherapy gross tumor volume (GTV) and clinical target volume (CTV) delineated by sarcoma radiation oncologists. Methods and Materials: Extremity sarcoma planning CT images along with the corresponding diagnostic MRI from two patients were distributed to 10 Radiation Therapy Oncology Group sarcoma radiation oncologists with instructions to define GTV and CTV using standardized guidelines. The CT data with contours were then returned for central analysis. Contours representing statistically corrected 95% (V95) and 100% (V100) agreement were computed for each structure. Results: For the GTV, the minimum, maximum, mean (SD) volumes (mL) were 674, 798, 752 ± 35 for the lower extremity case and 383, 543, 447 ± 46 for the upper extremity case. The volume (cc) of the union, V95 and V100 were 882, 761, and 752 for the lower, and 587, 461, and 455 for the upper extremity, respectively. The overall GTV agreement was judged to be almost perfect in both lower and upper extremity cases (kappa = 0.9 [p < 0.0001] and kappa = 0.86 [p < 0.0001]). For the CTV, the minimum, maximum, mean (SD) volumes (mL) were 1145, 1911, 1605 ± 211 for the lower extremity case and 637, 1246, 1006 ± 180 for the upper extremity case. The volume (cc) of the union, V95, and V100 were 2094, 1609, and 1593 for the lower, and 1533, 1020, and 965 for the upper extremity cases, respectively. The overall CTV agreement was judged to be almost perfect in the lower extremity case (kappa = 0.85 [p < 0.0001]) but only substantial in the upper extremity case (kappa = 0.77 [p < 0.0001]). Conclusions: Almost perfect agreement existed in the GTV of these two representative cases. Tshere was no significant disagreement in the CTV of the lower extremity, but variation in the CTV of upper extremity was seen, perhaps related to the positional differences between the planning CT and the diagnostic MRI.

AB - Purpose: To evaluate variability in the definition of preoperative radiotherapy gross tumor volume (GTV) and clinical target volume (CTV) delineated by sarcoma radiation oncologists. Methods and Materials: Extremity sarcoma planning CT images along with the corresponding diagnostic MRI from two patients were distributed to 10 Radiation Therapy Oncology Group sarcoma radiation oncologists with instructions to define GTV and CTV using standardized guidelines. The CT data with contours were then returned for central analysis. Contours representing statistically corrected 95% (V95) and 100% (V100) agreement were computed for each structure. Results: For the GTV, the minimum, maximum, mean (SD) volumes (mL) were 674, 798, 752 ± 35 for the lower extremity case and 383, 543, 447 ± 46 for the upper extremity case. The volume (cc) of the union, V95 and V100 were 882, 761, and 752 for the lower, and 587, 461, and 455 for the upper extremity, respectively. The overall GTV agreement was judged to be almost perfect in both lower and upper extremity cases (kappa = 0.9 [p < 0.0001] and kappa = 0.86 [p < 0.0001]). For the CTV, the minimum, maximum, mean (SD) volumes (mL) were 1145, 1911, 1605 ± 211 for the lower extremity case and 637, 1246, 1006 ± 180 for the upper extremity case. The volume (cc) of the union, V95, and V100 were 2094, 1609, and 1593 for the lower, and 1533, 1020, and 965 for the upper extremity cases, respectively. The overall CTV agreement was judged to be almost perfect in the lower extremity case (kappa = 0.85 [p < 0.0001]) but only substantial in the upper extremity case (kappa = 0.77 [p < 0.0001]). Conclusions: Almost perfect agreement existed in the GTV of these two representative cases. Tshere was no significant disagreement in the CTV of the lower extremity, but variation in the CTV of upper extremity was seen, perhaps related to the positional differences between the planning CT and the diagnostic MRI.

KW - Radiotherapy

KW - Sarcoma

KW - Target definition

UR - http://www.scopus.com/inward/record.url?scp=81855166666&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=81855166666&partnerID=8YFLogxK

U2 - 10.1016/j.ijrobp.2010.11.033

DO - 10.1016/j.ijrobp.2010.11.033

M3 - Article

C2 - 21277104

AN - SCOPUS:81855166666

VL - 81

JO - International Journal of Radiation Oncology Biology Physics

JF - International Journal of Radiation Oncology Biology Physics

SN - 0360-3016

IS - 5

ER -