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dc.contributor.authorMul, J
dc.contributor.authorMelchior, P
dc.contributor.authorSeravalli, E
dc.contributor.authorSaunders, D
dc.contributor.authorBolle, S
dc.contributor.authorCameron, AL
dc.contributor.authorGurtner, K
dc.contributor.authorHarrabi, S
dc.contributor.authorLassen-Ramshad, Y
dc.contributor.authorLavan, N
dc.contributor.authorMagelssen, H
dc.contributor.authorMandeville, H
dc.contributor.authorBoterberg, T
dc.contributor.authorKroon, PS
dc.contributor.authorKotte, ANTJ
dc.contributor.authorHoeben, BAW
dc.contributor.authorvan Rossum, PSN
dc.contributor.authorvan Grotel, M
dc.contributor.authorGraf, N
dc.contributor.authorvan den Heuvel-Eibrink, MM
dc.contributor.authorRübe, C
dc.contributor.authorJanssens, GO
dc.date.accessioned2021-07-29T10:32:19Z
dc.date.available2021-07-29T10:32:19Z
dc.identifier.citationClinical and translational radiation oncology, 2021, 28 pp. 39 - 47
dc.identifier.issn2405-6308
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/4712
dc.identifier.eissn2405-6308
dc.identifier.doi10.1016/j.ctro.2021.03.001
dc.description.abstractBackground and purpose Recently, the SIOP-RTSG developed a highly-conformal flank target volume definition for children with renal tumors. The aims of this study were to evaluate the inter-clinician delineation variation of this new target volume definition in an international multicenter setting and to explore the necessity of quality assurance.Materials and methods Six pediatric renal cancer cases were transferred to ten radiation oncologists from seven European countries ('participants'). These participants delineated the pre- and postoperative Gross Tumor Volume (GTV pre/post ), and Clinical Target Volume (CTV) during two test phases (case 1-2 and 3-4), followed by guideline refinement and a quality assurance phase (case 5-6). Reference target volumes (TV ref ) were established by three experienced radiation oncologists. The Dice Similarity Coefficient between the reference and participants (DSC ref/part ) was calculated per case. Delineations of case 5-6 were graded by four independent reviewers as 'per protocol' (0-4 mm), 'minor deviation' (5-9 mm) or 'major deviation' (≥10 mm) from the delineation guideline using 18 standardized criteria. Also, a major deviation resulting in underestimation of the CTV ref was regarded as an unacceptable variation.Results A total of 57/60 delineation sets were completed. The median DSC ref/part for the CTV was 0.55 without improvement after sequential cases (case 3-4 vs. case 5-6: p = 0.15). For case 5-6, a major deviation was found for 5/18, 12/17, 18/18 and 4/9 collected delineations of the GTV pre , GTV post , CTV-T and CTV-N, respectively. An unacceptable variation from the CTV ref was found for 7/9 participants for case 5 and 6/9 participants for case 6.Conclusion This international multicenter delineation exercise demonstrates that the new consensus for highly-conformal postoperative flank target volume delineation leads to geometrical variation among participants. Moreover, standardized review showed an unacceptable delineation variation in the majority of the participants. These findings strongly suggest the need for additional training and centralized pre-treatment review when this target volume delineation approach is implemented on a larger scale.
dc.formatElectronic-eCollection
dc.format.extent39 - 47
dc.languageeng
dc.language.isoeng
dc.rights.urihttps://creativecommons.org/licenses/by/4.0
dc.titleInter-clinician delineation variation for a new highly-conformal flank target volume in children with renal tumors: A SIOP-Renal Tumor Study Group international multicenter exercise.
dc.typeJournal Article
dcterms.dateAccepted2021-03-03
rioxxterms.versionVoR
rioxxterms.versionofrecord10.1016/j.ctro.2021.03.001
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by/4.0
rioxxterms.typeJournal Article/Review
dc.relation.isPartOfClinical and translational radiation oncology
pubs.notesNot known
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Paediatric and Adolescent Radiotherapy
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Paediatric and Adolescent Radiotherapy
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.publication-statusPublished
pubs.volume28
pubs.embargo.termsNot known
icr.researchteamPaediatric and Adolescent Radiotherapy
icr.researchteamPaediatric and Adolescent Radiotherapyen_US
dc.contributor.icrauthorMandeville, Henryen


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