TY - JOUR
T1 - Inter-observer variation in delineation of the heart and left anterior descending coronary artery in radiotherapy for breast cancer
T2 - A multi-centre study from Denmark and the UK
AU - Lorenzen, Ebbe L.
AU - Taylor, Carolyn W.
AU - Maraldo, Maja
AU - Nielsen, Mette H.
AU - Offersen, Birgitte V.
AU - Andersen, Maria R.
AU - O'Dwyer, Dean
AU - Larsen, Lone
AU - Duxbury, Sharon
AU - Jhitta, Baljit
AU - Darby, Sarah C.
AU - Ewertz, Marianne
AU - Brink, Carsten
PY - 2013/8/1
Y1 - 2013/8/1
N2 - Background and purpose To determine the extent of inter-observer variation in delineation of the heart and left anterior descending coronary artery (LADCA) and its impact on estimated doses. Methods and materials Nine observers from five centres delineated the heart and LADCA on fifteen patients receiving left breast radiotherapy. The delineations were carried out twice, first without guidelines and then with a set of common guidelines. Results For the heart, most spatial variation in delineation was near the base of the heart whereas for the LADCA most variation was in its length at the apex of the heart. Common guidelines reduced the spatial variation for the heart and the length of the LAD, but increased the variation in the anterior-posterior/right-left plane. The coefficients of variation (CV) in the estimated doses to the heart were: mean dose 7.5% without and 3.6% with guidelines, maximum dose 8.7% without and 4.0% with guidelines. The CVs in the estimated doses to the LADCA were: mean dose 27% without and 29% with guidelines, maximum dose 39% without and 31% with guidelines. Conclusions For the heart, there was little inter-observer variation in the estimated dose, especially when guidelines were used. In contrast, for the LADCA there was substantial variation in the estimated dose, which was not reduced with guidelines.
AB - Background and purpose To determine the extent of inter-observer variation in delineation of the heart and left anterior descending coronary artery (LADCA) and its impact on estimated doses. Methods and materials Nine observers from five centres delineated the heart and LADCA on fifteen patients receiving left breast radiotherapy. The delineations were carried out twice, first without guidelines and then with a set of common guidelines. Results For the heart, most spatial variation in delineation was near the base of the heart whereas for the LADCA most variation was in its length at the apex of the heart. Common guidelines reduced the spatial variation for the heart and the length of the LAD, but increased the variation in the anterior-posterior/right-left plane. The coefficients of variation (CV) in the estimated doses to the heart were: mean dose 7.5% without and 3.6% with guidelines, maximum dose 8.7% without and 4.0% with guidelines. The CVs in the estimated doses to the LADCA were: mean dose 27% without and 29% with guidelines, maximum dose 39% without and 31% with guidelines. Conclusions For the heart, there was little inter-observer variation in the estimated dose, especially when guidelines were used. In contrast, for the LADCA there was substantial variation in the estimated dose, which was not reduced with guidelines.
KW - Breast cancer radiotherapy
KW - Delineation
KW - Heart dose
KW - Inter-observer variation
KW - Left anterior descending coronary artery
U2 - 10.1016/j.radonc.2013.06.025
DO - 10.1016/j.radonc.2013.06.025
M3 - Journal article
C2 - 23891098
AN - SCOPUS:84885384631
SN - 0167-8140
VL - 108
SP - 254
EP - 258
JO - Radiotherapy & Oncology
JF - Radiotherapy & Oncology
IS - 2
ER -