Please use this identifier to cite or link to this item: http://dora.health.qld.gov.au/qldresearchjspui/handle/1/1603
Title: Assessing tumor centrality in lung stereotactic ablative body radiotherapy (SABR): the effects of variations in bronchial tree delineation and potential for automated methods
Authors: Ghandourh, Wsam
Dowling, Jason
Chlap, Phillip
Oar, Andrew 
Jacob, Susannah
Batumalai, Vikneswary
Holloway, Lois
Issue Date: Oct-2020
Publisher: Elsevier
Source: Ghandourh W, Dowling J, Chlap P, Oar A, Jacob S, Batumalai V, Holloway L. Assessing tumor centrality in lung stereotactic ablative body radiotherapy (SABR): the effects of variations in bronchial tree delineation and potential for automated methods. Med Dosim. 2021 Spring;46(1):94-101. doi: 10.1016/j.meddos.2020.09.004
Journal: Medical dosimetry : official journal of the American Association of Medical Dosimetrists
Abstract: Accurate delineation of the proximal bronchial tree (PBT) is crucial for appropriate assessment of lung tumor centrality and choice of Stereotactic Ablative Body Radiotherapy (SABR) dose prescription. Here, we investigate variabilities in manual PBT delineation and their potential to influence assessing lesion centrality. A fully automatic, intensity-based tool for PBT contouring and measuring distance to the target is also described. This retrospective analysis included a total of 61 patients treated with lung SABR. A subset of 41 patients was used as a training dataset, containing clinical PBT contour and additional subsequently generated manual contours. The tool was optimized and compared against manual contours in terms of volume, distance to the target and various overlap/similarity metrics. The remaining 20 patients were used as a validation dataset to investigate the dosimetric effects of variations between manual and automatic PBT contours. Considerable interobserver variability was observed, particularly in identifying the superior and inferior borders of the PBT. Automatic PBT contours were comparable to manual contours with average Dice of 0.63 to 0.79 and mean distance to agreement of 1.78 to 3.34 mm. No significant differences in dosimetric parameters were found between automatically and manually generated contours. A moderate negative correlation was found between PBT maximum dose and distance to the lesion (p < 0.05). Variability in manual PBT delineation may result in inconsistent assessment of tumor centrality. Automatic contouring can help standardize clinical practice, support investigations into the link between SABR outcomes and lesion proximity to central airways and the development of predictive toxicity models that incorporate precise measurements of tumor location in relation to high-risk organs.
DOI: 10.1016/j.meddos.2020.09.004
Keywords: Automatic contouring;NSCLC;Stereotactic radiotherapy;Central tumors;Contour variations
Type: Article
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