Atlas-based auto-contouring of breast tissue in young female lymphoma patients
Chamberlin, Hannah C Jaikuna, T. Anandadas, Carmel N Cowan, Richard A Astley, Susan Howell, Sacha J Radford, John A Azria, D. Enriquez, S. G. Rancati, T.
Chamberlin, Hannah C
Jaikuna, T.
Anandadas, Carmel N
Cowan, Richard A
Astley, Susan
Howell, Sacha J
Radford, John A
Azria, D.
Enriquez, S. G.
Rancati, T.
Citations
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Abstract
Purpose or Objective
Manual contouring adds to the RT planning workload, thus atlas-based auto-contouring tools (ABAC) have been explored for
several sites. Young women (<36yo) treated for lymphoma with supradiaphragmatic RT have an increased risk of developing
breast cancer (BC) compared to the general population, and would benefit from time of treatment breast contouring via
breast ABAC to minimise RT dose. However, there is limited published research in breast ABAC for non-BC patients. Here,
we evaluate the performance of ABAC developed on BC patients to contour breast tissue on young lymphoma patients, and
hypothesise that they will perform worse than ABAC specifically developed for lymphoma patients.
Materials and Methods
ABAC were built on 20 templates from 2 patient groups, including 10 female lymphoma patients (18-36yo, 8/10 arms down)
treated with supradiaphragmatic RT (ABAClymph) and 10 female BC patients (36-75yo, all arms up, 8/10 right-sided breast
RT) from the REQUITE study (ABACbreast). All contours were manually drawn by expert breast oncologists following ESTRO
guidelines without the 5mm crop from skin. A leave-one-out (LOO) approach in each group was implemented in RayStation
v6.99. Additionally, each LOO tool was applied to the other diagnostic group, generating 10 extra contours per patient (e.g.
each lymphoma patient had 1 ABAClymph and 10 ABACbreast contours). ABAC performance was evaluated using mean distance
to agreement (meanDTA) and Dice similarity coefficient (DSC). Metrics for the contour generated using the LOO approach
(i.e. using the other 9 patients in the same group) were compared to the averaged metric of the 10 extra contours (each
generated using 9 templates from the other group).
Results
Results are reported for left and right breasts combined (see table 1). Despite different age ranges, no significant difference
in breast volume or average breast density was observed between the two diagnostic groups. ABACbreast applied to BC
patients performed best; DSC median 0.89 (range 0.75-0.96), meanDTA 0.25cm (0.13-0.90) (see fig 1). Unexpectedly, when
applied to lymphoma patients, ABAClymph did not appear to perform better than ABACbreast; DSC 0.86 (0.46-0.91) vs 0.86
(0.56-0.94), meanDTA 0.28cm (0.14-0.82) vs 0.24cm (0.18-0.65). We also observed poorer performance on the left breast
than the right in all ABACs Conclusion
We could not confirm our hypothesis that lymphoma-specific ABAC performs better than ABAC developed using BC patients.
The disappointing performance of ABAC tools for breast contouring in young lymphoma patients suggests more sophisticated
methods might be needed in this complex population, e.g. specific atlases to account for variations in arm position and
different dense tissue distribution in the breast. We also found ESTRO guidelines need small adaptations to contour ‘breast
as an OAR’, which needs further exploration. The different performance between right and left breasts may be due to
differences in heart and lung shape and is the subject of ongoing work.
Authors
Chamberlin, Hannah C
Jaikuna, T.
Anandadas, Carmel N
Cowan, Richard A
Astley, Susan
Howell, Sacha J
Radford, John A
Azria, D.
Enriquez, S. G.
Rancati, T.
Rosenstein, B.
de Ruysscher, D.
Sperk, E.
Symonds, P.
Talbot, C.
De Santis, M. C.
Vega, A.
Veldeman, L.
Webb, A.
West, Catharine M L
Chang-Claude, J.
Seibold, P.
Lingard, Zoe
Vasquez Osorio, Eliana
Aznar, Marianne Camille
Jaikuna, T.
Anandadas, Carmel N
Cowan, Richard A
Astley, Susan
Howell, Sacha J
Radford, John A
Azria, D.
Enriquez, S. G.
Rancati, T.
Rosenstein, B.
de Ruysscher, D.
Sperk, E.
Symonds, P.
Talbot, C.
De Santis, M. C.
Vega, A.
Veldeman, L.
Webb, A.
West, Catharine M L
Chang-Claude, J.
Seibold, P.
Lingard, Zoe
Vasquez Osorio, Eliana
Aznar, Marianne Camille
Description
Date
2022
Publisher
Collections
Keywords
Type
Meetings and Proceedings
Citation
Chamberlin H, Jaikuna T, Anandadas C, Cowan R, Astley S, Howell S, et al. Atlas-based auto-contouring of breast tissue in young female lymphoma patients. Radiotherapy and Oncology. 2022 May;170:S150-S2. PubMed PMID: WOS:000806759200148.