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Variability in axillary lymph node delineation for breast cancer radiotherapy in presence of guidelines on a multi-institutional platform.

Variability in axillary lymph node delineation for breast cancer radiotherapy in presence of guidelines on a multi-institutional platform.

Authors :
Ciardo, Delia
Argenone, Angela
Boboc, Genoveva Ionela
Cucciarelli, Francesca
De Rose, Fiorenza
De Santis, Maria Carmen
Huscher, Alessandra
Ippolito, Edy
La Porta, Maria Rosa
Marino, Lorenza
Meaglia, Ilaria
Palumbo, Isabella
Rossi, Francesca
Alpi, Paolo
Bignardi, Mario
Bonanni, Alessio
Cante, Domenico
Ceschia, Tino
Fabbietti, Letizia
Lupattelli, Marco
Source :
Acta Oncologica; Aug2017, Vol. 56 Issue 8, p1081-1088, 8p, 1 Color Photograph, 2 Charts, 1 Graph
Publication Year :
2017

Abstract

Aim:To quantify the variability between radiation oncologists (ROs) when outlining axillary nodes in breast cancer. Material and methods:For each participating center, three ROs with different levels of expertise, i.e., junior (J), senior (S) and expert (E), contoured axillary nodal levels (L1, L2, L3 and L4) on the CT images of three different patients (P) of an increasing degree of anatomical complexity (from P1 to P2 to P3), according to contouring guidelines. Consensus contours were generated using the simultaneous truth and performance level estimation (STAPLE) method. Results:Fifteen centers and 42 ROs participated. Overall, the median Dice similarity coefficient was 0.66. Statistically significant differences were observed according to the level of expertise (better agreement for J and E, worse for S); the axillary level (better agreement for L1 and L4, worse for L3); the patient (better agreement for P1, worse for P3). Statistically significant differences in contouring were found in 18% of the inter-center comparison. Less than a half of the centers could claim to have a good agreement between the internal ROs. Conclusions:The overall intra-institute and inter-institute agreement was moderate. Central lymph-node levels were the most critical and variability increased as the complexity of the patient’s anatomy increased. These findings might have an effect on the interpretation of results from multicenter and even mono-institute studies. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
0284186X
Volume :
56
Issue :
8
Database :
Complementary Index
Journal :
Acta Oncologica
Publication Type :
Academic Journal
Accession number :
123325645
Full Text :
https://doi.org/10.1080/0284186X.2017.1325004