Many similarity metrics exist for inter-observer contouring variation studies, however no correlation between metric choice and prostate cancer radiotherapy dosimetry has been explored. These correlations were investigated in this study. Two separate trials were undertaken, the first a thirty-five patient cohort with three observers, the second a five patient dataset with ten observers. Clinical and planning target volumes (CTV and PTV), rectum, and bladder were independently contoured by all observers in each trial. Structures were contoured on T2-weighted MRI and transferred onto CT following rigid registration for treatment planning in the first trial. Structures were contoured directly on CT in the second trial. STAPLE and majority voting volumes were generated as reference gold standard volumes for each structure for the two trials respectively. VMAT treatment plans (78 Gy to PTV) were simulated for observer and gold standard volumes, and dosimetry assessed using multiple radiobiological metrics. Correlations between contouring similarity metrics and dosimetry were calculated using Spearman's rank correlation coefficient. No correlations were observed between contouring similarity metrics and dosimetry for CTV within either trial. Volume similarity correlated most strongly with radiobiological metrics for PTV in both trials, including TCP_Poisson (ρ = 0.57, 0.65), TCP_Logit (ρ = 0.39, 0.62), and EUD (ρ = 0.43, 0.61) for each respective trial. Rectum and bladder metric correlations displayed no consistency for the two trials. PTV volume similarity was found to significantly correlate with rectum normal tissue complication probability (NTCP) (ρ = 0.33, 0.48). Minimal to no correlations with dosimetry were observed for overlap or boundary contouring metrics. Future inter-observer contouring variation studies for prostate cancer should incorporate volume similarity to provide additional insights into dosimetry during analysis.
Physics in medicine and biology. 2018 Jan 04 [Epub ahead of print]
Dale Roach, Michael G Jameson, Jason A Dowling, Martin Andrew Ebert, Peter B Greer, Angel M Kennedy, Sandie Watt, Lois C Holloway
South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, AUSTRALIA., Ingham Institute for Applied Medical Research, Sydney, New South Wales, AUSTRALIA., e-Health Research Centre, CSIRO, Herston, Queensland, AUSTRALIA., Sir Charles Gairdner Hospital, Nedlands, AUSTRALIA., Department of Radiation Oncology, Calvary Mater Newcastle, Newcastle, New South Wales, AUSTRALIA., Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, AUSTRALIA., Liverpool Cancer Therapy Centre, Liverpool Hospital, Sydney, New South Wales, AUSTRALIA.