一项关于前庭神经鞘瘤立体定向放射外科手术的单中心、观察者间评估及其剂量学影响
A single center, inter-observer evaluation of vestibular schwannoma stereotactic radiosurgery and its dosimetric impact.
作者信息
Perez-Calatayud Maria Jose, Menéndez Antonio, Lliso Françoise, Carmona Vicente, Conde Antonio, Celada Francisco, Bernisz Mariola, Botella Carlos, Perez-Calatayud Jose
机构信息
Radiotherapy Department, Hospital La Fe, Valencia, Spain.
Neurosurgery Department, Hospital La Fe, Valencia, Spain.
出版信息
J Radiosurg SBRT. 2024;9(2):113-120.
The aim of this work was to evaluate the inter- and intra-observer variation in contouring vestibular schwannoma (VS) and the organs-at-risk (OAR), and its dosimetric impact in Volumetric Modulated Arc Therapy (VMAT). Three VS typical cases were contoured by four clinicians. The Agreement Volume Index (AVI) appeared to be notably higher in VS than in OARs, such that the dose coverage of VS is fairly robust. In OARs, the largest variation was +1.02Gy in dmax for the brainstem, +0.78Gy in dmean for the cochlea and +1.05Gy in dmax of the trigeminal nerve. Accordingly, it was decided that all VS delineations for stereotactic radiosurgery (SRS), and all frame-based SRS contouring in general, should always be reviewed by a second physician. In addition, the retrospective presentation of VS cases at daily peer review meetings has also been adopted to ensure that the consensus is constantly updated, as well as for training purposes.
这项工作的目的是评估在勾画前庭神经鞘瘤（VS）和危及器官（OAR）时观察者之间和观察者内部的差异，以及其在容积调强弧形放疗（VMAT）中的剂量学影响。三名VS典型病例由四名临床医生进行勾画。一致性体积指数（AVI）在VS中似乎明显高于在OAR中，因此VS的剂量覆盖相当稳健。在OAR中，最大差异为脑干的dmax增加1.02Gy，耳蜗的dmean增加0.78Gy，三叉神经的dmax增加1.05Gy。因此，决定立体定向放射外科（SRS）的所有VS勾画，以及一般所有基于框架的SRS勾画，都应由第二位医生进行审查。此外，还采用了在每日同行评审会议上回顾VS病例的方式，以确保共识不断更新，同时也用于培训目的。
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