Rivin Del Campo Eleonor, Rivera Sofia, Martínez-Paredes María, Hupé Philippe, Slocker Escarpa Andrea, Borget Isabelle, Mazeron Renaud, Scholl Suzy, Palacios Eito Amalia, Haie-Meder Christine, Chargari Cyrus, Deutsch Eric
Department of Radiation Oncology, Gustave Roussy Cancer Campus, Villejuif, France.
Department of Radiation Oncology, Gustave Roussy Cancer Campus, Villejuif, France.
Radiother Oncol. 2017 Jul;124(1):130-138. doi: 10.1016/j.radonc.2017.05.008. Epub 2017 May 19.
Online delineation workshops (ODW) permit training of geographically dispersed participants. The purpose is to evaluate the methodology of an ODW using FALCON to harmonize delineation within a European multicentre trial on locally advanced cervical cancer (LACC).
Two ODW included 46 clinicians (14 centres). Clinicians completed baseline (C1), guideline (C2) and final contours (C3) for external beam radiotherapy (EBRT) and brachytherapy (BT) for LACC. Interobserver and intraobserver variability was evaluated quantitatively (using the DICE index) and qualitatively compared to expert contours.
Nine clinicians submitted for EBRT and BT for C1-C3. Thirty-two sent any contour. Interobserver quantitative comparisons for EBRT showed significant improvement for C2 vs. C1 for bowel, CTV node, CTV-p and GTV node with significant detriment for GTV node (C3 vs. C1; C2), CTV-p (C3 vs. C2) and bowel (C3 vs. C2), showing in general an improvement in C2 vs. C1, with a detriment in C3 vs. C2 for two target volumes and an organ at risk. For BT there was significant improvement for C2 vs. C1 for bladder, GTV, HR-CTV and IR-CTV, with significant detriment for bladder (C3 vs. C2), thus overall improvement in C2 vs. C1, with only a detriment in C3 vs. C2 for bladder. Centres using MRI imaging for BT contouring did significantly better in the BT case for HR-CTV than those which used other techniques (C2 vs. C1: p<0.005; C3 vs. C1: p=0.02). Intraobserver quantitative comparisons showed significant improvement contouring a region of interest between C2 vs. C1, C3 vs. C1 and C3 vs. C2 for EBRT and between C2 and C1 for BT.
ODW offer training, initial contouring harmonization and allow assessment of centres.
在线勾画研讨会（ODW）允许对地理位置分散的参与者进行培训。目的是评估在一项关于局部晚期宫颈癌（LACC）的欧洲多中心试验中使用FALCON进行ODW以协调勾画的方法。
两次ODW包括46名临床医生（14个中心）。临床医生完成了LACC的外照射放疗（EBRT）和近距离放疗（BT）的基线（C1）、指南（C2）和最终轮廓（C3）。观察者间和观察者内的变异性通过定量（使用DICE指数）进行评估，并与专家轮廓进行定性比较。
9名临床医生提交了C1 - C3的EBRT和BT轮廓。32人发送了任何轮廓。EBRT的观察者间定量比较显示，对于C2与C1，肠道、CTV淋巴结、CTV - p和GTV淋巴结有显著改善，而对于GTV淋巴结（C3与C1；C2）、CTV - p（C3与C2）和肠道（C3与C2）有显著损害，总体显示C2与C1有改善，对于两个靶区体积和一个危及器官，C3与C2有损害。对于BT，C2与C1时膀胱、GTV、HR - CTV和IR - CTV有显著改善，对于膀胱（C3与C2）有显著损害，因此总体C2与C1有改善，仅膀胱在C3与C2时有损害。在BT病例中，使用MRI成像进行轮廓勾画的中心在HR - CTV方面比使用其他技术的中心表现明显更好（C2与C1：p < 0.005；C3与C1：p = 0.02）。观察者内定量比较显示，对于EBRT，在C2与C1、C3与C1以及C3与C2之间勾画感兴趣区域有显著改善，对于BT，在C2与C1之间有显著改善。
ODW提供培训、初始轮廓协调并允许对各中心进行评估。
