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MRI reduces variation of contouring for boost clinical target volume in breast cancer patients without surgical clips in the tumour bed

Noora Al-Hammadi

Noora Al-Hammadi

Department of Radiation Oncology, National Center for Cancer Care and Research, Hamad Medical CorporationDoha, Qatar
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Al-Hammadi, Noora
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Palmira Caparrotti

Palmira Caparrotti

Department of Radiation Oncology, National Center for Cancer Care and Research, Hamad Medical CorporationDoha, Qatar
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Caparrotti, Palmira
, 
Saju Divakar

Saju Divakar

Department of Radiation Oncology, National Center for Cancer Care and Research, Hamad Medical CorporationDoha, Qatar
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Divakar, Saju
, 
Mohamed Riyas

Mohamed Riyas

Department of Radiation Oncology, National Center for Cancer Care and Research, Hamad Medical CorporationDoha, Qatar
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Riyas, Mohamed
, 
Suparna Halsnad Chandramouli

Suparna Halsnad Chandramouli

Department of Radiation Oncology, National Center for Cancer Care and Research, Hamad Medical CorporationDoha, Qatar
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Chandramouli, Suparna Halsnad
, 
Rabih Hammoud

Rabih Hammoud

Department of Radiation Oncology, National Center for Cancer Care and Research, Hamad Medical CorporationDoha, Qatar
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Hammoud, Rabih
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Jillian Hayes

Jillian Hayes

Department of Radiation Oncology, National Center for Cancer Care and Research, Hamad Medical CorporationDoha, Qatar
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Hayes, Jillian
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Maeve Mc Garry

Maeve Mc Garry

Department of Radiation Oncology, National Center for Cancer Care and Research, Hamad Medical CorporationDoha, Qatar
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Mc Garry, Maeve
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Satheesh Prasad Paloor

Satheesh Prasad Paloor

Department of Radiation Oncology, National Center for Cancer Care and Research, Hamad Medical CorporationDoha, Qatar
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Paloor, Satheesh Prasad
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Primoz Petric

Primoz Petric

Department of Radiation Oncology, National Center for Cancer Care and Research, Hamad Medical CorporationDoha, Qatar
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Petric, Primoz
  
Mar 17, 2017
MRI reduces variation of contouring for boost clinical target volume in breast cancer patients without surgical clips in the tumour bed's Cover Image
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Article Category: Research Articles
Published Online: Mar 17, 2017
Page range: 160 - 168
Received: Dec 05, 2016
Accepted: Feb 19, 2017
DOI: https://doi.org/10.1515/raon-2017-0014
Keywords
© 2017 Noora Al-Hammadi, Palmira Caparrotti, Saju Divakar, Mohamed Riyas, Suparna Halsnad Chandramouli, Rabih Hammoud, Jillian Hayes, Maeve Mc Garry, Satheesh Prasad Paloor, Primoz Petric
This article is distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
(A) Generalized conformity index (CIgen) and (B) accuracy index (AI) as a function of the cavity visualization score (CVS) for CT and MRI based contouring of lumpectomy cavity clinical target volume. None of the patients had surgical clips inserted in the tumor bed. Case numbers are indicated for each modality.
(A) Generalized conformity index (CIgen) and (B) accuracy index (AI) as a function of the cavity visualization score (CVS) for CT and MRI based contouring of lumpectomy cavity clinical target volume. None of the patients had surgical clips inserted in the tumor bed. Case numbers are indicated for each modality.
CT and MRI based contouring in two examples with high and low cavity visualization scores (CVS). Observers’ delineations are white and expert consensus (EC) contours black. (A) Case with a CVS of 4.8 on CT and 5 on MRI: mean generalized conformity index (CIgen), accuracy index (AI) and inter-delineation distance (IDD) were 0.79, 0.85 and 2.4 mm on CT and 0.80, 0.86 and 2.2 mm on MRI. (B) Case with a CVS of 2 on CT and 3 on MRI: mean CIgen, AI and IDD were 0.46, 0.61 and 6 mm for CT and 0.63, 0.73 and 4.5 mm for MRI.
CT and MRI based contouring in two examples with high and low cavity visualization scores (CVS). Observers’ delineations are white and expert consensus (EC) contours black. (A) Case with a CVS of 4.8 on CT and 5 on MRI: mean generalized conformity index (CIgen), accuracy index (AI) and inter-delineation distance (IDD) were 0.79, 0.85 and 2.4 mm on CT and 0.80, 0.86 and 2.2 mm on MRI. (B) Case with a CVS of 2 on CT and 3 on MRI: mean CIgen, AI and IDD were 0.46, 0.61 and 6 mm for CT and 0.63, 0.73 and 4.5 mm for MRI.

Accuracy index (AI) and inter-delineation distances (IDD), based on the expert consensus (EC) delineation as the reference_ The differences in AI and IDD between CT and MRI were statistically significant (p < 0_05)

CTMRI
Case
IDD [mm]AIIDD [mm]AI
MeanSDCoV [%]MeanSDCoV [%]Mean(SD)CoV [%]MeanSDCoV [%]
12.10.8380.880.0231.80.58320.880.012
23.61.9530.780.1123.21.9590.830.023
33.92.6670.670.07103.21.8560.780.022
42.31430.750.0682.30.9390.770.056
564670.610.15244.52.1470.730.1420
62.61.1420.820.0222.61380.830.022
764.1680.640.09143.61.8500.760.057
82.41.2500.850.0222.21450.860.044
932.9970.810.0452.91.8620.800.056
104.53.5780.770.0793.32610.840.022
113.32610.740.09122.51.3520.830.023
123.42.3680.770.0683.61.7470.800.022
MEAN3.62.3610.760.07931.5490.810.045

Results for inter-observer variation in contouring_ The difference in mean generalized conformity index (CIgen) between the CT and MRI based contouring was statistically significant (p = 0_007)

CaseCTMRI
Mean V [cm3] (SD)CoV [%]CIgenMean V [cm3] (SD)CoV [%]CIgen
1198 (10)50.85106 (4)40.87
2241 (37.5)160.69256 (28)110.77
3108 (20.7)190.56125 (10)80.75
475 (18.1)240.6492 (12)130.69
5175 (47.9)270.46217 (68)310.63
6140 (10.1)70.76125 (14)110.76
7103(39.7)390.4864 (2)40.66
8180 (22.5)120.79158 (14)90.8
9135 (19.8)150.77126 (20)160.71
10204 (44.3)220.68215 (19)90.76
1199 (14.4)150.66135 (11)80.79
12195 (27.3)140.69210 (29)140.74
MEAN (SD)154 (26)180.67 (0.12)152 (19)120.74 (0.07)
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