Consequences of introducing geometric GTV to CTV margin expansion in DAHANCA contouring guidelines for head and neck radiotherapy

Christian Rønn Hansen, Jørgen Johansen, Eva Samsøe, Elo Andersen, Jørgen B B Petersen, Kenneth Jensen, Lisbeth J Andersen, Hella M B Sand, Anders S Bertelsen, Cai Grau

Publikation: Bidrag til bog/antologi/rapport/konference proceedingKonferenceabstrakt i proceedingForskningpeer review

Resumé

BACKGROUND AND PURPOSE: Defining margins around the Gross Tumour Volume (GTV) to create a Clinical Target Volume (CTV) for head and neck cancer radiotherapy has traditionally been based on presumed knowledge of anatomical routes of spread. However, using a concentric geometric expansion around the GTV may be more reproducible. The purpose of this study was to analyse the inter-observer consistency of geometric CTV delineation with adaptation for anatomical boundaries versus anatomically defined CTVs.

MATERIAL AND METHODS: Radiation oncologists at four Danish cancer centres delineated high, intermediate and elective dose CTVs (CTV1, CTV2 and CTV3, respectively) in a patient-case template (stage IV squamous cell carcinoma of the oropharynx), first using mainly anatomical margins (original standard) and then using concentric geometric expansion (new standard). Each centre made a dummy-run radiotherapy plan based on the delineated CTVs. The difference between the CTV contours and the radiotherapy plans was evaluated across the centres.

RESULTS: Anatomy-based contours were significantly more heterogenous and showed larger volume differences between centres than geometric margins. Dice similarity coefficient increased by 0.29 and mean surface distance decreased by 4mm for CTV1. Use of consistent CTV volumes resulted in more consistent irradiated volumes between centres.

CONCLUSION: Introduction of geometric margins resulted in more uniform CTV1 and CTV2 delineation. Geometric CTV expansion was easier, left less room for misinterpretation, and resulted in more uniform treatment plans with similar irradiated high and intermediate dose volumes across all centres.

OriginalsprogEngelsk
TitelDanske Kræftforskningsdage : Abstract Book
Publikationsdato2018
Sider30
Artikelnummer#24
StatusUdgivet - 2018
BegivenhedDanske Kræftforskningsdage 2018 - Odeon Konferencecenter, Odense, Danmark
Varighed: 30 aug. 201831 aug. 2018
http://www.dccc.dk/danske-kraeftforskningsdage/danske-kraftforskningsdage-2018/

Konference

KonferenceDanske Kræftforskningsdage 2018
LokationOdeon Konferencecenter
LandDanmark
ByOdense
Periode30/08/201831/08/2018
Internetadresse

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Tumor Burden
Neck
Radiotherapy
Head
Guidelines
Oropharynx
Head and Neck Neoplasms
Squamous Cell Carcinoma
Anatomy
Neoplasms
Therapeutics

Emneord

    Citer dette

    Hansen, C. R., Johansen, J., Samsøe, E., Andersen, E., Petersen, J. B. B., Jensen, K., ... Grau, C. (2018). Consequences of introducing geometric GTV to CTV margin expansion in DAHANCA contouring guidelines for head and neck radiotherapy. I Danske Kræftforskningsdage: Abstract Book (s. 30). [#24]
    Hansen, Christian Rønn ; Johansen, Jørgen ; Samsøe, Eva ; Andersen, Elo ; Petersen, Jørgen B B ; Jensen, Kenneth ; Andersen, Lisbeth J ; Sand, Hella M B ; Bertelsen, Anders S ; Grau, Cai. / Consequences of introducing geometric GTV to CTV margin expansion in DAHANCA contouring guidelines for head and neck radiotherapy. Danske Kræftforskningsdage: Abstract Book. 2018. s. 30
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    abstract = "BACKGROUND AND PURPOSE: Defining margins around the Gross Tumour Volume (GTV) to create a Clinical Target Volume (CTV) for head and neck cancer radiotherapy has traditionally been based on presumed knowledge of anatomical routes of spread. However, using a concentric geometric expansion around the GTV may be more reproducible. The purpose of this study was to analyse the inter-observer consistency of geometric CTV delineation with adaptation for anatomical boundaries versus anatomically defined CTVs.MATERIAL AND METHODS: Radiation oncologists at four Danish cancer centres delineated high, intermediate and elective dose CTVs (CTV1, CTV2 and CTV3, respectively) in a patient-case template (stage IV squamous cell carcinoma of the oropharynx), first using mainly anatomical margins (original standard) and then using concentric geometric expansion (new standard). Each centre made a dummy-run radiotherapy plan based on the delineated CTVs. The difference between the CTV contours and the radiotherapy plans was evaluated across the centres.RESULTS: Anatomy-based contours were significantly more heterogenous and showed larger volume differences between centres than geometric margins. Dice similarity coefficient increased by 0.29 and mean surface distance decreased by 4mm for CTV1. Use of consistent CTV volumes resulted in more consistent irradiated volumes between centres.CONCLUSION: Introduction of geometric margins resulted in more uniform CTV1 and CTV2 delineation. Geometric CTV expansion was easier, left less room for misinterpretation, and resulted in more uniform treatment plans with similar irradiated high and intermediate dose volumes across all centres.",
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    author = "Hansen, {Christian R{\o}nn} and J{\o}rgen Johansen and Eva Sams{\o}e and Elo Andersen and Petersen, {J{\o}rgen B B} and Kenneth Jensen and Andersen, {Lisbeth J} and Sand, {Hella M B} and Bertelsen, {Anders S} and Cai Grau",
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    Hansen, CR, Johansen, J, Samsøe, E, Andersen, E, Petersen, JBB, Jensen, K, Andersen, LJ, Sand, HMB, Bertelsen, AS & Grau, C 2018, Consequences of introducing geometric GTV to CTV margin expansion in DAHANCA contouring guidelines for head and neck radiotherapy. i Danske Kræftforskningsdage: Abstract Book., #24, s. 30, Danske Kræftforskningsdage 2018, Odense, Danmark, 30/08/2018.

    Consequences of introducing geometric GTV to CTV margin expansion in DAHANCA contouring guidelines for head and neck radiotherapy. / Hansen, Christian Rønn; Johansen, Jørgen; Samsøe, Eva; Andersen, Elo; Petersen, Jørgen B B; Jensen, Kenneth; Andersen, Lisbeth J; Sand, Hella M B; Bertelsen, Anders S; Grau, Cai.

    Danske Kræftforskningsdage: Abstract Book. 2018. s. 30 #24.

    Publikation: Bidrag til bog/antologi/rapport/konference proceedingKonferenceabstrakt i proceedingForskningpeer review

    TY - ABST

    T1 - Consequences of introducing geometric GTV to CTV margin expansion in DAHANCA contouring guidelines for head and neck radiotherapy

    AU - Hansen, Christian Rønn

    AU - Johansen, Jørgen

    AU - Samsøe, Eva

    AU - Andersen, Elo

    AU - Petersen, Jørgen B B

    AU - Jensen, Kenneth

    AU - Andersen, Lisbeth J

    AU - Sand, Hella M B

    AU - Bertelsen, Anders S

    AU - Grau, Cai

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

    PY - 2018

    Y1 - 2018

    N2 - BACKGROUND AND PURPOSE: Defining margins around the Gross Tumour Volume (GTV) to create a Clinical Target Volume (CTV) for head and neck cancer radiotherapy has traditionally been based on presumed knowledge of anatomical routes of spread. However, using a concentric geometric expansion around the GTV may be more reproducible. The purpose of this study was to analyse the inter-observer consistency of geometric CTV delineation with adaptation for anatomical boundaries versus anatomically defined CTVs.MATERIAL AND METHODS: Radiation oncologists at four Danish cancer centres delineated high, intermediate and elective dose CTVs (CTV1, CTV2 and CTV3, respectively) in a patient-case template (stage IV squamous cell carcinoma of the oropharynx), first using mainly anatomical margins (original standard) and then using concentric geometric expansion (new standard). Each centre made a dummy-run radiotherapy plan based on the delineated CTVs. The difference between the CTV contours and the radiotherapy plans was evaluated across the centres.RESULTS: Anatomy-based contours were significantly more heterogenous and showed larger volume differences between centres than geometric margins. Dice similarity coefficient increased by 0.29 and mean surface distance decreased by 4mm for CTV1. Use of consistent CTV volumes resulted in more consistent irradiated volumes between centres.CONCLUSION: Introduction of geometric margins resulted in more uniform CTV1 and CTV2 delineation. Geometric CTV expansion was easier, left less room for misinterpretation, and resulted in more uniform treatment plans with similar irradiated high and intermediate dose volumes across all centres.

    AB - BACKGROUND AND PURPOSE: Defining margins around the Gross Tumour Volume (GTV) to create a Clinical Target Volume (CTV) for head and neck cancer radiotherapy has traditionally been based on presumed knowledge of anatomical routes of spread. However, using a concentric geometric expansion around the GTV may be more reproducible. The purpose of this study was to analyse the inter-observer consistency of geometric CTV delineation with adaptation for anatomical boundaries versus anatomically defined CTVs.MATERIAL AND METHODS: Radiation oncologists at four Danish cancer centres delineated high, intermediate and elective dose CTVs (CTV1, CTV2 and CTV3, respectively) in a patient-case template (stage IV squamous cell carcinoma of the oropharynx), first using mainly anatomical margins (original standard) and then using concentric geometric expansion (new standard). Each centre made a dummy-run radiotherapy plan based on the delineated CTVs. The difference between the CTV contours and the radiotherapy plans was evaluated across the centres.RESULTS: Anatomy-based contours were significantly more heterogenous and showed larger volume differences between centres than geometric margins. Dice similarity coefficient increased by 0.29 and mean surface distance decreased by 4mm for CTV1. Use of consistent CTV volumes resulted in more consistent irradiated volumes between centres.CONCLUSION: Introduction of geometric margins resulted in more uniform CTV1 and CTV2 delineation. Geometric CTV expansion was easier, left less room for misinterpretation, and resulted in more uniform treatment plans with similar irradiated high and intermediate dose volumes across all centres.

    KW - Journal Article

    M3 - Conference abstract in proceeding

    SP - 30

    BT - Danske Kræftforskningsdage

    ER -

    Hansen CR, Johansen J, Samsøe E, Andersen E, Petersen JBB, Jensen K et al. Consequences of introducing geometric GTV to CTV margin expansion in DAHANCA contouring guidelines for head and neck radiotherapy. I Danske Kræftforskningsdage: Abstract Book. 2018. s. 30. #24