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Interobserver variability in gross tumor volume delineation for hepatocellular carcinoma : Results of Korean Radiation Oncology Group 1207 study

 Young Suk Kim  ;  Jun Won Kim  ;  Won Sup Yoon  ;  Min Kyu Kang  ;  Ik Jae Lee  ;  Tae Hyun Kim  ;  Jin Hee Kim  ;  Hyung-Sik Lee  ;  Hee Chul Park  ;  Hong Seok Jang  ;  Chul Seung Kay  ;  Sang Min Yoon  ;  Mi-Sook Kim  ;  Jinsil Seong 
 STRAHLENTHERAPIE UND ONKOLOGIE, Vol.192(10) : 714-721, 2016 
Journal Title
Issue Date
Adult ; Aged ; Carcinoma, Hepatocellular/diagnostic imaging* ; Carcinoma, Hepatocellular/pathology* ; Clinical Competence* ; Female ; Humans ; Liver Neoplasms/diagnostic imaging* ; Liver Neoplasms/pathology* ; Male ; Middle Aged ; Neoplasm Staging ; Observer Variation ; Reproducibility of Results ; Republic of Korea ; Sensitivity and Specificity ; Tumor Burden*
Chemoembolization ; Organs at risk ; Quality assurance ; Radiofrequency ablation ; Radiotherapy
PURPOSE: There has been increasing use of external beam radiotherapy for localized treatment of hepatocellular carcinoma (HCC) with both palliative and curative intent. Quality control of target delineation in primary HCC is essential to deliver adequate doses of radiation to the primary tumor while preserving adjacent healthy organs. We analyzed interobserver variability in gross tumor volume (GTV) delineation for HCC. PATIENTS AND METHODS: Twelve radiation oncologists specializing in liver malignancy participated in a multi-institutional contouring dummy-run study of nine HCC cases and independently delineated GTV on the same set of provided computed tomography images. Quantitative analysis was performed using an expectation maximization algorithm for simultaneous truth and performance level estimation (STAPLE) with kappa statistics calculating agreement between physicians. To quantify the interobserver variability of GTV delineations, the ratio of the actual delineated volume to the estimated consensus volume (STAPLE), the ratio of the common and encompassing volumes, and the coefficient of variation were calculated. RESULTS: The median kappa agreement level was 0.71 (range 0.28-0.86). The ratio of the actual delineated volume to the estimated consensus volume ranged from 0.19 to 1.93 (median 0.94) for all cases. The ratio of the common and encompassing volumes ranged from 0.001 to 0.56 (median 0.25). The coefficient of variation for GTV delineation ranged from 8 to 57?% (median 26?%). CONCLUSION: The interobserver variability in target delineation of HCC GTV in this study is noteworthy. Multi-institution studies involving radiotherapy for HCC require appropriate quality assurance programs for target delineation.
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1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jun Won(김준원) ORCID logo https://orcid.org/0000-0003-1358-364X
Seong, Jin Sil(성진실) ORCID logo https://orcid.org/0000-0003-1794-5951
Lee, Ik Jae(이익재) ORCID logo https://orcid.org/0000-0001-7165-3373
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