Evaluating the relationship between contouring variability and modelled treatment outcome for prostate bed radiotherapy
Details
Publication Year 2024-03-12,Volume 69,Issue #8,Page 085008
Journal Title
Physics in Medicine and Biology
Publication Type
Research article
Abstract
OBJECTIVES: Contouring similarity metrics are often used in studies of inter-observer variation and automatic segmentation but do not provide an assessment of clinical impact. This study focused on post-prostatectomy radiotherapy and aimed to 1) identify if there is a relationship between variations in commonly used contouring similarity metrics and resulting dosimetry and 2) identify the variation in clinical target volume (CTV) contouring that significantly impacts dosimetry. APPROACH: The study retrospectively analysed CT scans of 10 patients from the TROG 08.03 RAVES trial. The CTV, rectum, and bladder were contoured independently by three experienced observers. Using these contours reference simultaneous truth and performance level estimation (STAPLE) volumes were established. Additional CTVs were generated using an atlas algorithm based on a single benchmark case with 42 manual contours. Volumetric-modulated arc therapy (VMAT) treatment plans were generated for the observer, atlas, and reference volumes. The dosimetry was evaluated using radiobiological metrics. Correlations between contouring similarity and dosimetry metrics were calculated using Spearman coefficient (г). To access impact of variations in PTV margin, the STAPLE planning target volume (PTV) was uniformly contracted and expanded, with plans created for each PTV volume. STAPLE dose-volume histograms (DVHs) were exported for plans generated based on the contracted/expanded volumes, and dose-volume metrics assessed. MAIN RESULTS: The study found no strong correlations between the considered similarity metrics and modelled outcomes. Moderate correlations (0.5 < |г| < 0.7) were observed for Dice similarity coefficient, Jaccard, and mean distance to agreement metrics and rectum toxicities. The observations of this study indicate a tendency for variations in CTV contraction/expansion below 5 mm to result in minor dosimetric impacts. SIGNIFICANCE: Contouring similarity metrics must be used with caution when interpreting them as indicators of treatment plan variation. For post-prostatectomy VMAT patients, this work showed variations in contours with an expansion/contraction of less than 5 mm did not lead to notable dosimetric differences, this should be explored in a larger dataset to assess generalisability.
Publisher
IOP Publishing
Keywords
Vmat; correlation; prostate bed; radiobiology; similarity metrics
Department(s)
Radiation Oncology
Open Access at Publisher's Site
https://doi.org/10.1088/1361-6560/ad3325
Terms of Use/Rights Notice
Refer to copyright notice on published article.


Creation Date: 2024-04-04 02:32:06
Last Modified: 2024-04-04 03:11:41

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