Interobserver variability in organ delineation on radiotherapy treatment planning for nasopharyngeal carcinoma: A dosimetric and prognostic analysis
Background and purposeThis study aimed to analyze the impact of interobserver variability (IOV) on clinical dosimetry and prognosis, specifically investigating the correlation between IOV and clinical prognosis in the context of intensity-modulated radiation therapy (IMRT) for nasopharyngeal carcino...
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Frontiers Media S.A.
2025-05-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2025.1510568/full |
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| author | Meining Chen Yinglin Peng Ruotong Chen Qiuying Xie Dengyuan Chen Jinping Shi Rong Huang Jun Zhang Chong Zhao Li Chen Xiaowu Deng Yimei Liu |
| author_facet | Meining Chen Yinglin Peng Ruotong Chen Qiuying Xie Dengyuan Chen Jinping Shi Rong Huang Jun Zhang Chong Zhao Li Chen Xiaowu Deng Yimei Liu |
| author_sort | Meining Chen |
| collection | DOAJ |
| description | Background and purposeThis study aimed to analyze the impact of interobserver variability (IOV) on clinical dosimetry and prognosis, specifically investigating the correlation between IOV and clinical prognosis in the context of intensity-modulated radiation therapy (IMRT) for nasopharyngeal carcinoma (NPC).Materials and methodsTwelve NPC patients who underwent IMRT were selected. Four radiotherapy physicians from two different-tier cancer centers independently delineated target volumes and organs at risk (OARs) for each patient. These delineations were compared against gold standard structures from a regional cancer center. The IOV among physicians and its effect on clinical and prognosis were analyzed. The relationships between the IOV, dosimetry, and prognosis were investigated using spearman’s correlation analysis.ResultsThe target volume and OARs delineation differed significantly among physicians. This variability led to reduced prescription dose coverage (PDC) of the planning target volume (PTV) and increased doses to OARs, impacting tumor control probability (TCP) and normal tissue complication probability (NTCP). Compared to standard delineations, all four physicians showed decreased TCPs (average decrease in ΔTCP >1%) and a significant increase in NTCPs of OARs. The relative volume difference (ΔV) of target volumes correlated strongly with ΔPDC (R=0.686) and ΔTCP (R=0.703). Moreover, in the validation set, ΔV also strongly correlated with ΔTCP (R = 0.778).ConclusionSubstantial IOV in delineating NPC target volumes and OARs for IMRT was observed. This variability affects plan optimization, dose distribution, and clinical prognosis. ΔV can serve as a risk predictor for assessing delineation variability in NPC radiotherapy treatment planning. |
| format | Article |
| id | doaj-art-d1e3f09ef0834775bba795f4da0b7acc |
| institution | Kabale University |
| issn | 2234-943X |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj-art-d1e3f09ef0834775bba795f4da0b7acc2025-08-20T03:53:12ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-05-011510.3389/fonc.2025.15105681510568Interobserver variability in organ delineation on radiotherapy treatment planning for nasopharyngeal carcinoma: A dosimetric and prognostic analysisMeining Chen0Yinglin Peng1Ruotong Chen2Qiuying Xie3Dengyuan Chen4Jinping Shi5Rong Huang6Jun Zhang7Chong Zhao8Li Chen9Xiaowu Deng10Yimei Liu11Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, ChinaDepartment of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, ChinaDepartment of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, ChinaDepartment of Radiation Oncology, the First People’s Hospital of Foshan, Foshan, ChinaDepartment of Radiation Oncology, Luoding People’s Hospital, Yunfu, ChinaDepartment of Radiation Oncology, the First People’s Hospital of Foshan, Foshan, ChinaDepartment of Radiation Oncology, the First People’s Hospital of Foshan, Foshan, ChinaDepartment of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, ChinaDepartment of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, ChinaDepartment of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, ChinaDepartment of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, ChinaDepartment of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, ChinaBackground and purposeThis study aimed to analyze the impact of interobserver variability (IOV) on clinical dosimetry and prognosis, specifically investigating the correlation between IOV and clinical prognosis in the context of intensity-modulated radiation therapy (IMRT) for nasopharyngeal carcinoma (NPC).Materials and methodsTwelve NPC patients who underwent IMRT were selected. Four radiotherapy physicians from two different-tier cancer centers independently delineated target volumes and organs at risk (OARs) for each patient. These delineations were compared against gold standard structures from a regional cancer center. The IOV among physicians and its effect on clinical and prognosis were analyzed. The relationships between the IOV, dosimetry, and prognosis were investigated using spearman’s correlation analysis.ResultsThe target volume and OARs delineation differed significantly among physicians. This variability led to reduced prescription dose coverage (PDC) of the planning target volume (PTV) and increased doses to OARs, impacting tumor control probability (TCP) and normal tissue complication probability (NTCP). Compared to standard delineations, all four physicians showed decreased TCPs (average decrease in ΔTCP >1%) and a significant increase in NTCPs of OARs. The relative volume difference (ΔV) of target volumes correlated strongly with ΔPDC (R=0.686) and ΔTCP (R=0.703). Moreover, in the validation set, ΔV also strongly correlated with ΔTCP (R = 0.778).ConclusionSubstantial IOV in delineating NPC target volumes and OARs for IMRT was observed. This variability affects plan optimization, dose distribution, and clinical prognosis. ΔV can serve as a risk predictor for assessing delineation variability in NPC radiotherapy treatment planning.https://www.frontiersin.org/articles/10.3389/fonc.2025.1510568/fullintensity-modulated radiotherapyinterobserver variabilitynormal tissue complication probabilitytumor control probabilitynasopharyngeal carcinoma |
| spellingShingle | Meining Chen Yinglin Peng Ruotong Chen Qiuying Xie Dengyuan Chen Jinping Shi Rong Huang Jun Zhang Chong Zhao Li Chen Xiaowu Deng Yimei Liu Interobserver variability in organ delineation on radiotherapy treatment planning for nasopharyngeal carcinoma: A dosimetric and prognostic analysis Frontiers in Oncology intensity-modulated radiotherapy interobserver variability normal tissue complication probability tumor control probability nasopharyngeal carcinoma |
| title | Interobserver variability in organ delineation on radiotherapy treatment planning for nasopharyngeal carcinoma: A dosimetric and prognostic analysis |
| title_full | Interobserver variability in organ delineation on radiotherapy treatment planning for nasopharyngeal carcinoma: A dosimetric and prognostic analysis |
| title_fullStr | Interobserver variability in organ delineation on radiotherapy treatment planning for nasopharyngeal carcinoma: A dosimetric and prognostic analysis |
| title_full_unstemmed | Interobserver variability in organ delineation on radiotherapy treatment planning for nasopharyngeal carcinoma: A dosimetric and prognostic analysis |
| title_short | Interobserver variability in organ delineation on radiotherapy treatment planning for nasopharyngeal carcinoma: A dosimetric and prognostic analysis |
| title_sort | interobserver variability in organ delineation on radiotherapy treatment planning for nasopharyngeal carcinoma a dosimetric and prognostic analysis |
| topic | intensity-modulated radiotherapy interobserver variability normal tissue complication probability tumor control probability nasopharyngeal carcinoma |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2025.1510568/full |
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