Multiple training interventions significantly improve reproducibility of PET/CT-based lung cancer radiotherapy target volume delineation using an IAEA study protocol

Tom Konert, Wouter Vogel, Sarah Everitt, Michael P MacManus, Daniela Thorwarth, Elena Fidarova, Diana Paez, Jan-Jakob Sonke, Gerard G. Hanna

Research output: Contribution to journalArticle

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Abstract

BACKGROUND AND PURPOSE: To assess the impact of a standardized delineation protocol and training interventions on PET/CT-based target volume delineation (TVD) in NSCLC in a multicenter setting.

MATERIAL AND METHODS: Over a one-year period, 11 pairs, comprised each of a radiation oncologist and nuclear medicine physician with limited experience in PET/CT-based TVD for NSCLC from nine different countries took part in a training program through an International Atomic Energy Agency (IAEA) study (NCT02247713). Teams delineated gross tumor volume of the primary tumor, during and after training interventions, according to a provided delineation protocol. In-house developed software recorded the performed delineations, to allow visual inspection of strategies and to assess delineation accuracy.

RESULTS: Following the first training, overall concordance indices for 3 repetitive cases increased from 0.57±0.07 to 0.66±0.07. The overall mean surface distance between observer and expert contours decreased from -0.40±0.03 cm to -0.01±0.33 cm. After further training overall concordance indices for another 3 repetitive cases further increased from 0.64±0.06 to 0.80±0.05 (p=0.01). Mean surface distances decreased from -0.34±0.16 cm to -0.05±0.20 cm (p=0.01).

CONCLUSION: Multiple training interventions improve PET/CT-based TVD delineation accuracy in NSCLC and reduces interobserver variation.
Original languageEnglish
Pages (from-to)39-45
Number of pages7
JournalRadiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Volume121
Issue number1
Early online date20 Sep 2016
DOIs
Publication statusPublished - Oct 2016

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Nuclear Energy
Observer Variation
Nuclear Medicine
Tumor Burden
Lung Neoplasms
Radiotherapy
Software
Physicians
Education
Neoplasms
Radiation Oncologists

Bibliographical note

This study reports a 3-year project of training intervention project which I conducted and led. Cancer Treatment Centres in 8 different low or middle income countries where trained on the use of PET/CT for radiotherapy planning in lung cancer. We analysed the accuracy of the participating centres to undertake lung cancer radiotherapy target volume delineation. We demonstrated that a one off training course is not sufficient to implement enduring change but rather the multiple training events using different platforms of learning are required. This project was coordinated through the International Atomic Energy Agency (IAEA) and has been published in the World’s leading radiotherapy journal.

Keywords

  • PET/CT
  • lung cancer
  • Radiotherapy
  • Target Volume Delineation

Cite this

Konert, Tom ; Vogel, Wouter ; Everitt, Sarah ; MacManus, Michael P ; Thorwarth, Daniela ; Fidarova, Elena ; Paez, Diana ; Sonke, Jan-Jakob ; Hanna, Gerard G. / Multiple training interventions significantly improve reproducibility of PET/CT-based lung cancer radiotherapy target volume delineation using an IAEA study protocol. In: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology. 2016 ; Vol. 121, No. 1. pp. 39-45.
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Multiple training interventions significantly improve reproducibility of PET/CT-based lung cancer radiotherapy target volume delineation using an IAEA study protocol. / Konert, Tom; Vogel, Wouter; Everitt, Sarah; MacManus, Michael P; Thorwarth, Daniela; Fidarova, Elena; Paez, Diana; Sonke, Jan-Jakob; Hanna, Gerard G.

In: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology, Vol. 121, No. 1, 10.2016, p. 39-45.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Multiple training interventions significantly improve reproducibility of PET/CT-based lung cancer radiotherapy target volume delineation using an IAEA study protocol

AU - Konert, Tom

AU - Vogel, Wouter

AU - Everitt, Sarah

AU - MacManus, Michael P

AU - Thorwarth, Daniela

AU - Fidarova, Elena

AU - Paez, Diana

AU - Sonke, Jan-Jakob

AU - Hanna, Gerard G.

N1 - This study reports a 3-year project of training intervention project which I conducted and led. Cancer Treatment Centres in 8 different low or middle income countries where trained on the use of PET/CT for radiotherapy planning in lung cancer. We analysed the accuracy of the participating centres to undertake lung cancer radiotherapy target volume delineation. We demonstrated that a one off training course is not sufficient to implement enduring change but rather the multiple training events using different platforms of learning are required. This project was coordinated through the International Atomic Energy Agency (IAEA) and has been published in the World’s leading radiotherapy journal.

PY - 2016/10

Y1 - 2016/10

N2 - BACKGROUND AND PURPOSE: To assess the impact of a standardized delineation protocol and training interventions on PET/CT-based target volume delineation (TVD) in NSCLC in a multicenter setting.MATERIAL AND METHODS: Over a one-year period, 11 pairs, comprised each of a radiation oncologist and nuclear medicine physician with limited experience in PET/CT-based TVD for NSCLC from nine different countries took part in a training program through an International Atomic Energy Agency (IAEA) study (NCT02247713). Teams delineated gross tumor volume of the primary tumor, during and after training interventions, according to a provided delineation protocol. In-house developed software recorded the performed delineations, to allow visual inspection of strategies and to assess delineation accuracy. RESULTS: Following the first training, overall concordance indices for 3 repetitive cases increased from 0.57±0.07 to 0.66±0.07. The overall mean surface distance between observer and expert contours decreased from -0.40±0.03 cm to -0.01±0.33 cm. After further training overall concordance indices for another 3 repetitive cases further increased from 0.64±0.06 to 0.80±0.05 (p=0.01). Mean surface distances decreased from -0.34±0.16 cm to -0.05±0.20 cm (p=0.01).CONCLUSION: Multiple training interventions improve PET/CT-based TVD delineation accuracy in NSCLC and reduces interobserver variation.

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KW - PET/CT

KW - lung cancer

KW - Radiotherapy

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