Interobserver variability in the delineation of the tumour bed using seroma and surgical clips based on 4DCT scan for ex
- PDF / 1,928,899 Bytes
- 7 Pages / 595.276 x 793.701 pts Page_size
- 6 Downloads / 172 Views
RESEARCH
Open Access
Interobserver variability in the delineation of the tumour bed using seroma and surgical clips based on 4DCT scan for external-beam partial breast irradiation Bing Guo1,2, Jianbin Li1*, Wei Wang1, Min Xu1, Qian Shao1, Yingjie Zhang1, Chaoqian Liang1 and Yanluan Guo1,2
Abstract Background: To explore the interobserver variability in the delineation of the tumour bed using seroma and surgical clips based on the four-dimensional computed tomography (4DCT) scan for external-beam partial breast irradiation (EB-PBI) during free breathing. Methods: Patients with a seroma clarity score (SCS) 3 ~ 5 and ≥5 surgical clips in the lumpectomy cavity after breast-conserving surgery who were recruited for EB-PBI underwent 4DCT simulation. Based on the ten sets of 4DCT images acquired, the tumour bed formed using the clips, the seroma, and both the clips and seroma (defined as TBC, TBS and TBC+S, respectively) were delineated by five radiation oncologists using specific guidelines. The following parameters were calculated to analyse interobserver variability: volume of the tumour bed (TBC, TBS, TBC+S), coefficient of variation (COVC, COVS, COVC+S), and matching degree (MDC, MDS, MDC+S). Results: The interobserver variability for TBC and TBC+S and for COVC and COVC+S were statistically significant (p = 0.021, 0.008, 0.002, 0.015). No significant difference was observed for TBS and COVS (p = 0.867, 0.061). Significant differences in interobserver variability were observed for MDC vs MDS, MDC vs MDC+S, MDS vs MDC+S (p = 0.000, 0.032, 0.008), the interobserver variability of MDS was smaller than that of MDC and MDC+S (MDS > MDC+S > MDC). Conclusions: When the SCS was 3 ~ 5 points and the number of surgical clips was ≥5, interobserver variability was minimal for the delineation of the tumour bed based on seroma. Keywords: Breast cancer, Four-dimensional computed tomography, Interobserver variability, Surgical clips, Seroma
Background Breast-conserving therapy (BCT), which involves a wide local excision followed by radiotherapy to the whole breast, is the standard treatment for early-stage breast cancer [1]. The efficacy of BCT for the treatment of earlystage breast carcinoma has been established in multiple randomised trials [2,3]. External-beam partial breast irradiation (EB-PBI) has recently garnered increasing interest [4,5]. Several studies reported that EB-PBI, which delivers radiotherapy to the postoperative tumour bed (TB) with a margin of adjacent breast tissue, could achieve * Correspondence: [email protected] 1 Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Jiyan Road, Jinan, Shandong Province 250117, China Full list of author information is available at the end of the article
excellent results in certain patients. However, there are inherent challenges in defining accurate target volumes for partial breast irradiation (PBI). Studies demonstrate significant interobserver variability between radiation oncologists in defining the lumpectomy cavity, indicating the need to impro
Data Loading...
