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Target delineation variability and corresponding margins of peripheral early stage NSCLC treated with stereotactic body radiotherapy


Peulen, Heike; Belderbos, José; Guckenberger, Matthias; Hope, Andrew; Grills, Inga; van Herk, Marcel; Sonke, Jan-Jakob (2015). Target delineation variability and corresponding margins of peripheral early stage NSCLC treated with stereotactic body radiotherapy. Radiotherapy and Oncology, 114(3):361-366.

Abstract

PURPOSE To quantify the target delineation variability in peripheral early stage lung cancer treated with SBRT and derive corresponding margins.
METHODS AND MATERIALS Sixteen early stage NSCLC GTV's were delineated by 11 radiation oncologists from 4 institutes. A median surface was computed and the delineation variation perpendicular to this surface was measured (local standard deviation=SD). The overall target delineation variability was quantified by the root-mean-square (rms) of the local SD. The required margin was determined by expanding all delineations to encompass the median surface, where after the underlying probability distribution was modeled by a number of uncorrelated 'pimples-and-dimples'.
RESULTS The overall target delineation variability was 2.1mm (rms). Institute I-III delineated significantly smaller volumes than institute IV, yielding target delineation variabilities of 1.2mm and 1.8mm respectively. The margin required to obtain 90% coverage of the delineated contours was 3.4mm and 5.9mm respectively. The factor α in M=αΣ required to calculate adequate margins was 2.8-3.2, which is larger than the 2.5 found for 3D rigid target displacement.
CONCLUSION A relatively small target delineation uncertainty of 1.2mm-1.8mm (1SD) was observed for early stage NSCLC. A 3.4-5.9mm GTV-to-PTV margin was required to account for this uncertainty alone, ignoring other sources of geometric uncertainties.

Abstract

PURPOSE To quantify the target delineation variability in peripheral early stage lung cancer treated with SBRT and derive corresponding margins.
METHODS AND MATERIALS Sixteen early stage NSCLC GTV's were delineated by 11 radiation oncologists from 4 institutes. A median surface was computed and the delineation variation perpendicular to this surface was measured (local standard deviation=SD). The overall target delineation variability was quantified by the root-mean-square (rms) of the local SD. The required margin was determined by expanding all delineations to encompass the median surface, where after the underlying probability distribution was modeled by a number of uncorrelated 'pimples-and-dimples'.
RESULTS The overall target delineation variability was 2.1mm (rms). Institute I-III delineated significantly smaller volumes than institute IV, yielding target delineation variabilities of 1.2mm and 1.8mm respectively. The margin required to obtain 90% coverage of the delineated contours was 3.4mm and 5.9mm respectively. The factor α in M=αΣ required to calculate adequate margins was 2.8-3.2, which is larger than the 2.5 found for 3D rigid target displacement.
CONCLUSION A relatively small target delineation uncertainty of 1.2mm-1.8mm (1SD) was observed for early stage NSCLC. A 3.4-5.9mm GTV-to-PTV margin was required to account for this uncertainty alone, ignoring other sources of geometric uncertainties.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Radiation Oncology
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:March 2015
Deposited On:24 Sep 2015 15:58
Last Modified:05 Apr 2016 19:25
Publisher:Elsevier
ISSN:0167-8140
Publisher DOI:https://doi.org/10.1016/j.radonc.2015.02.011
PubMed ID:25770872

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