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Reliability and accuracy assessment of radiation therapy oncology group-endorsed guidelines for brachial plexus contouring

Joris Van de Velde (UGent) , Tom Vercauteren (UGent) , Werner De Gersem (UGent) , Johan Wouters (UGent) , Katrien Vandecasteele (UGent) , Philippe Vuye (UGent) , Frank Vanpachtenbeke (UGent) , Katharina D'Herde (UGent) , Ingrid Kerckaert (UGent) , Wilfried De Neve (UGent) , et al.
(2014) STRAHLENTHERAPIE UND ONKOLOGIE. 190(7). p.628-635
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Abstract
The goal of this work was to validate the Radiation Therapy Oncology Group (RTOG)-endorsed guidelines for brachial plexus (BP) contouring by determining the intra- and interobserver agreement. Accuracy of the delineation process was determined using anatomically validated imaging datasets as a gold standard. Five observers delineated the right BP on three cadaver computed tomography (CT) datasets. To assess intraobserver variation, every observer repeated each delineation three times with a time interval of 2 weeks. The BP contours were divided into four regions for detailed analysis. Inter- and intraobserver variation was verified using the Computerized Environment for Radiation Research (CERR) software. Accuracy was measured using anatomically validated fused CT-magnetic resonance imaging (MRI) datasets by measuring the BP inclusion of the delineations. The overall kappa (kappa) values were rather low (mean interobserver overall kappa: 0.29, mean intraobserver overall kappa: 0.45), indicating poor inter- and intraobserver reliability. In general, the kappa coefficient decreased gradually from the medial to lateral BP regions. The total agreement volume (TAV) was much smaller than the union volume (UV) for all delineations, resulting in a low Jaccard index (JI; interobserver agreement 0-0.124; intraobserver agreement 0.004-0.636). The overall accuracy was poor, with an average total BP inclusion of 38 %. Inclusions were insufficient for the most lateral regions (region 3: 21.5 %; region 4: 12.6 %). The inter- and intraobserver reliability of the RTOG-endorsed BP contouring guidelines was poor. BP inclusion worsened from the medial to lateral regions. Accuracy assessment of the contours showed an average BP inclusion of 38 %. For the first time, this was assessed using the original anatomically validated BP volume. The RTOG-endorsed BP guidelines have insufficient accuracy and reliability, especially for the lateral head-and-neck regions.
Keywords
Delineation, Brachial plexus, Reliability and validity, Cadaver, Validation studies, NECK CANCER, TARGET VOLUMES, BREAST-CANCER, RADIOTHERAPY, HEAD, DELINEATION, VALIDATION, IMAGES, DEFINITION, ORGANS

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MLA
Van de Velde, Joris, et al. “Reliability and Accuracy Assessment of Radiation Therapy Oncology Group-Endorsed Guidelines for Brachial Plexus Contouring.” STRAHLENTHERAPIE UND ONKOLOGIE, vol. 190, no. 7, 2014, pp. 628–35, doi:10.1007/s00066-014-0657-6.
APA
Van de Velde, J., Vercauteren, T., De Gersem, W., Wouters, J., Vandecasteele, K., Vuye, P., … Van Hoof, T. (2014). Reliability and accuracy assessment of radiation therapy oncology group-endorsed guidelines for brachial plexus contouring. STRAHLENTHERAPIE UND ONKOLOGIE, 190(7), 628–635. https://doi.org/10.1007/s00066-014-0657-6
Chicago author-date
Van de Velde, Joris, Tom Vercauteren, Werner De Gersem, Johan Wouters, Katrien Vandecasteele, Philippe Vuye, Frank Vanpachtenbeke, et al. 2014. “Reliability and Accuracy Assessment of Radiation Therapy Oncology Group-Endorsed Guidelines for Brachial Plexus Contouring.” STRAHLENTHERAPIE UND ONKOLOGIE 190 (7): 628–35. https://doi.org/10.1007/s00066-014-0657-6.
Chicago author-date (all authors)
Van de Velde, Joris, Tom Vercauteren, Werner De Gersem, Johan Wouters, Katrien Vandecasteele, Philippe Vuye, Frank Vanpachtenbeke, Katharina D’Herde, Ingrid Kerckaert, Wilfried De Neve, and Tom Van Hoof. 2014. “Reliability and Accuracy Assessment of Radiation Therapy Oncology Group-Endorsed Guidelines for Brachial Plexus Contouring.” STRAHLENTHERAPIE UND ONKOLOGIE 190 (7): 628–635. doi:10.1007/s00066-014-0657-6.
Vancouver
1.
Van de Velde J, Vercauteren T, De Gersem W, Wouters J, Vandecasteele K, Vuye P, et al. Reliability and accuracy assessment of radiation therapy oncology group-endorsed guidelines for brachial plexus contouring. STRAHLENTHERAPIE UND ONKOLOGIE. 2014;190(7):628–35.
IEEE
[1]
J. Van de Velde et al., “Reliability and accuracy assessment of radiation therapy oncology group-endorsed guidelines for brachial plexus contouring,” STRAHLENTHERAPIE UND ONKOLOGIE, vol. 190, no. 7, pp. 628–635, 2014.
@article{5684614,
  abstract     = {{The goal of this work was to validate the Radiation Therapy Oncology Group (RTOG)-endorsed guidelines for brachial plexus (BP) contouring by determining the intra- and interobserver agreement. Accuracy of the delineation process was determined using anatomically validated imaging datasets as a gold standard.
Five observers delineated the right BP on three cadaver computed tomography (CT) datasets. To assess intraobserver variation, every observer repeated each delineation three times with a time interval of 2 weeks. The BP contours were divided into four regions for detailed analysis. Inter- and intraobserver variation was verified using the Computerized Environment for Radiation Research (CERR) software. Accuracy was measured using anatomically validated fused CT-magnetic resonance imaging (MRI) datasets by measuring the BP inclusion of the delineations.
The overall kappa (kappa) values were rather low (mean interobserver overall kappa: 0.29, mean intraobserver overall kappa: 0.45), indicating poor inter- and intraobserver reliability. In general, the kappa coefficient decreased gradually from the medial to lateral BP regions. The total agreement volume (TAV) was much smaller than the union volume (UV) for all delineations, resulting in a low Jaccard index (JI; interobserver agreement 0-0.124; intraobserver agreement 0.004-0.636). The overall accuracy was poor, with an average total BP inclusion of 38 %. Inclusions were insufficient for the most lateral regions (region 3: 21.5 %; region 4: 12.6 %).
The inter- and intraobserver reliability of the RTOG-endorsed BP contouring guidelines was poor. BP inclusion worsened from the medial to lateral regions. Accuracy assessment of the contours showed an average BP inclusion of 38 %. For the first time, this was assessed using the original anatomically validated BP volume. The RTOG-endorsed BP guidelines have insufficient accuracy and reliability, especially for the lateral head-and-neck regions.}},
  author       = {{Van de Velde, Joris and Vercauteren, Tom and De Gersem, Werner and Wouters, Johan and Vandecasteele, Katrien and Vuye, Philippe and Vanpachtenbeke, Frank and D'Herde, Katharina and Kerckaert, Ingrid and De Neve, Wilfried and Van Hoof, Tom}},
  issn         = {{0179-7158}},
  journal      = {{STRAHLENTHERAPIE UND ONKOLOGIE}},
  keywords     = {{Delineation,Brachial plexus,Reliability and validity,Cadaver,Validation studies,NECK CANCER,TARGET VOLUMES,BREAST-CANCER,RADIOTHERAPY,HEAD,DELINEATION,VALIDATION,IMAGES,DEFINITION,ORGANS}},
  language     = {{eng}},
  number       = {{7}},
  pages        = {{628--635}},
  title        = {{Reliability and accuracy assessment of radiation therapy oncology group-endorsed guidelines for brachial plexus contouring}},
  url          = {{http://doi.org/10.1007/s00066-014-0657-6}},
  volume       = {{190}},
  year         = {{2014}},
}

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