On the trail of CBCT-guided adaptive rectal boost radiotherapy, does daily delineation require a radiation oncologist?
Introduction: Dose-escalation radiotherapy for rectal tumours is increasingly considered as a non-operative approach, with online-adaptive radiotherapy (oART) supporting this approach by correcting inter-fraction tumour position errors. However, using cone-beam computed tomography (CBCT)-guided oART...
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Elsevier
2024-12-01
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| Series: | Technical Innovations & Patient Support in Radiation Oncology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405632424000519 |
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| author | Julien Pierrard David Dechambre Christel Abdel Massih Sophie Cvilic Ana Da Silva Chambel Roma Pascale Henderickx Sofie Heylen Eleonore Longton Romain Mony Mohamed Amine Tenabene Thaïs Tison Ad Vandermeulen Loïc Vander Veken Aniko Wale Etume Anne-Emmanuella Yeo Geneviève Van Ooteghem |
| author_facet | Julien Pierrard David Dechambre Christel Abdel Massih Sophie Cvilic Ana Da Silva Chambel Roma Pascale Henderickx Sofie Heylen Eleonore Longton Romain Mony Mohamed Amine Tenabene Thaïs Tison Ad Vandermeulen Loïc Vander Veken Aniko Wale Etume Anne-Emmanuella Yeo Geneviève Van Ooteghem |
| author_sort | Julien Pierrard |
| collection | DOAJ |
| description | Introduction: Dose-escalation radiotherapy for rectal tumours is increasingly considered as a non-operative approach, with online-adaptive radiotherapy (oART) supporting this approach by correcting inter-fraction tumour position errors. However, using cone-beam computed tomography (CBCT)-guided oART requires daily target volume delineation by different operators, leading to inter-operator delineation variability and potential dosimetric issues. This study aims to compare and quantify the inter-operator and inter-professional delineation variability of the rectal boost volume on CBCT, including volumes by an automatically delineated oART treatment planning system. Materials and methods: A rectal boost volume, defined as the primary tumour extended to the entire adjacent rectal wall, was delineated on 10 CBCTs from 5 patients by 15 operators: 4 expert radiation oncologists (ROs), 4 radiation therapists (RTTs) and 7 non-expert ROs. These contours were compared between the different professional groups. A comparison to the average volume of the group (ROs, RTTs, or non-expert ROs) with the lowest delineation variability was also performed for each individual volume including the volume automatically generated by an oART treatment planning system. Results: Delineation variability was the highest in the superior (range: 2.3–6.0 mm), and inferior (2.3–12.4 mm) directions, compared to the left (0.2–4.4 mm), right (0.3–2.0 mm), anterior (0.1–2.9 mm), and posterior (0.5–4.0 mm) directions. Non-expert ROs, RTTs, and automatic oART volume showed similar ranges of delineation errors when compared to the expert ROs’ volume, which was chosen as reference volume since this professional group showed the lowest variability. Discussion: Expert ROs showed consistent results. Other professional groups exhibit similar variability, comparable to the automatic oART volume. Therefore, RTTs could safely perform the rectal boost delineation without non-expert ROs supervision in the absence of expert ROs during CBCT-based oART. Moreover, these findings provide quantitative data to compute accurate margins for the rectal boost planning target volume in a CBCT-guided oART workflow. |
| format | Article |
| id | doaj-art-d2b987cfd93c4bfe89818405bffac3a7 |
| institution | OA Journals |
| issn | 2405-6324 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
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| series | Technical Innovations & Patient Support in Radiation Oncology |
| spelling | doaj-art-d2b987cfd93c4bfe89818405bffac3a72025-08-20T01:56:44ZengElsevierTechnical Innovations & Patient Support in Radiation Oncology2405-63242024-12-013210028410.1016/j.tipsro.2024.100284On the trail of CBCT-guided adaptive rectal boost radiotherapy, does daily delineation require a radiation oncologist?Julien Pierrard0David Dechambre1Christel Abdel Massih2Sophie Cvilic3Ana Da Silva Chambel Roma4Pascale Henderickx5Sofie Heylen6Eleonore Longton7Romain Mony8Mohamed Amine Tenabene9Thaïs Tison10Ad Vandermeulen11Loïc Vander Veken12Aniko Wale Etume13Anne-Emmanuella Yeo14Geneviève Van Ooteghem15UCLouvain, Institut de Recherche Experimentale et Clinique (IREC), Center of Molecular Imaging, Radiotherapy and Oncology (MIRO), Brussels, Belgium; Department of Radiation Oncology, Cliniques Universitaires Saint-Luc, Brussels, Belgium; Corresponding author at: Avenue Hippocrate 54, boîte B1.54.07, UCLouvain, Institut de Recherche Experimentale et Clinique (IREC), Center of Molecular Imaging, Radiotherapy and Oncology (MIRO), Brussels, Belgium.Department of Radiation Oncology, Cliniques Universitaires Saint-Luc, Brussels, BelgiumDepartment of Radiation Oncology, Cliniques Universitaires Saint-Luc, Brussels, BelgiumDepartment of Radiation Oncology, Cliniques Universitaires Saint-Luc, Brussels, BelgiumDepartment of Radiation Oncology, Cliniques Universitaires Saint-Luc, Brussels, BelgiumDepartment of Radiation Oncology, Cliniques Universitaires Saint-Luc, Brussels, BelgiumDepartment of Radiation Oncology, Cliniques Universitaires Saint-Luc, Brussels, BelgiumDepartment of Radiation Oncology, Cliniques Universitaires Saint-Luc, Brussels, BelgiumDepartment of Radiation Oncology, Centre Henri Becquerel, Rouen, FranceDepartment of Radiation Oncology, Cliniques Universitaires Saint-Luc, Brussels, BelgiumDepartment of Radiation Oncology, Cliniques Universitaires Saint-Luc, Brussels, BelgiumDepartment of Radiation Oncology, Cliniques Universitaires Saint-Luc, Brussels, BelgiumUCLouvain, Institut de Recherche Experimentale et Clinique (IREC), Center of Molecular Imaging, Radiotherapy and Oncology (MIRO), Brussels, Belgium; Department of Radiation Oncology, Cliniques Universitaires Saint-Luc, Brussels, BelgiumDepartment of Radiation Oncology, Cliniques Universitaires Saint-Luc, Brussels, BelgiumDepartment of Radiation Oncology, Cliniques Universitaires Saint-Luc, Brussels, BelgiumUCLouvain, Institut de Recherche Experimentale et Clinique (IREC), Center of Molecular Imaging, Radiotherapy and Oncology (MIRO), Brussels, Belgium; Department of Radiation Oncology, Cliniques Universitaires Saint-Luc, Brussels, BelgiumIntroduction: Dose-escalation radiotherapy for rectal tumours is increasingly considered as a non-operative approach, with online-adaptive radiotherapy (oART) supporting this approach by correcting inter-fraction tumour position errors. However, using cone-beam computed tomography (CBCT)-guided oART requires daily target volume delineation by different operators, leading to inter-operator delineation variability and potential dosimetric issues. This study aims to compare and quantify the inter-operator and inter-professional delineation variability of the rectal boost volume on CBCT, including volumes by an automatically delineated oART treatment planning system. Materials and methods: A rectal boost volume, defined as the primary tumour extended to the entire adjacent rectal wall, was delineated on 10 CBCTs from 5 patients by 15 operators: 4 expert radiation oncologists (ROs), 4 radiation therapists (RTTs) and 7 non-expert ROs. These contours were compared between the different professional groups. A comparison to the average volume of the group (ROs, RTTs, or non-expert ROs) with the lowest delineation variability was also performed for each individual volume including the volume automatically generated by an oART treatment planning system. Results: Delineation variability was the highest in the superior (range: 2.3–6.0 mm), and inferior (2.3–12.4 mm) directions, compared to the left (0.2–4.4 mm), right (0.3–2.0 mm), anterior (0.1–2.9 mm), and posterior (0.5–4.0 mm) directions. Non-expert ROs, RTTs, and automatic oART volume showed similar ranges of delineation errors when compared to the expert ROs’ volume, which was chosen as reference volume since this professional group showed the lowest variability. Discussion: Expert ROs showed consistent results. Other professional groups exhibit similar variability, comparable to the automatic oART volume. Therefore, RTTs could safely perform the rectal boost delineation without non-expert ROs supervision in the absence of expert ROs during CBCT-based oART. Moreover, these findings provide quantitative data to compute accurate margins for the rectal boost planning target volume in a CBCT-guided oART workflow.http://www.sciencedirect.com/science/article/pii/S2405632424000519Rectum radiotherapyCBCT-guided radiotherapyRectum boostDelineation variabilityRadiation Therapists |
| spellingShingle | Julien Pierrard David Dechambre Christel Abdel Massih Sophie Cvilic Ana Da Silva Chambel Roma Pascale Henderickx Sofie Heylen Eleonore Longton Romain Mony Mohamed Amine Tenabene Thaïs Tison Ad Vandermeulen Loïc Vander Veken Aniko Wale Etume Anne-Emmanuella Yeo Geneviève Van Ooteghem On the trail of CBCT-guided adaptive rectal boost radiotherapy, does daily delineation require a radiation oncologist? Technical Innovations & Patient Support in Radiation Oncology Rectum radiotherapy CBCT-guided radiotherapy Rectum boost Delineation variability Radiation Therapists |
| title | On the trail of CBCT-guided adaptive rectal boost radiotherapy, does daily delineation require a radiation oncologist? |
| title_full | On the trail of CBCT-guided adaptive rectal boost radiotherapy, does daily delineation require a radiation oncologist? |
| title_fullStr | On the trail of CBCT-guided adaptive rectal boost radiotherapy, does daily delineation require a radiation oncologist? |
| title_full_unstemmed | On the trail of CBCT-guided adaptive rectal boost radiotherapy, does daily delineation require a radiation oncologist? |
| title_short | On the trail of CBCT-guided adaptive rectal boost radiotherapy, does daily delineation require a radiation oncologist? |
| title_sort | on the trail of cbct guided adaptive rectal boost radiotherapy does daily delineation require a radiation oncologist |
| topic | Rectum radiotherapy CBCT-guided radiotherapy Rectum boost Delineation variability Radiation Therapists |
| url | http://www.sciencedirect.com/science/article/pii/S2405632424000519 |
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