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    Use of a novel atlas for muscles of mastication to reduce inter observer variability in head and neck radiotherapy contouring.

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    Authors
    Hague, Christina
    Beasley, William J
    Dixon, Lynne
    Gaito, Simona
    Garcez, Kate
    Green, Andrew
    Lee, Lip W
    Maranzano, M
    McPartlin, Andrew J
    Mistry, Hitesh
    Mullan, Damian
    Sykes, Andrew J
    Thomson, David J
    van Herk, Marcel
    West, Catharine ML
    Slevin, Nicholas J
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    Affiliation
    Department of Head and Neck Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK
    Issue Date
    2018
    
    Metadata
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    Abstract
    PURPOSE/OBJECTIVE(S): Trismus is caused by injury to the masticatory muscles resulting from cancer or its treatment. Contouring these muscles to reduce dose and radiation related trismus can be problematic due to interobserver variability. This study aimed to evaluate the reduction in interobserver variability achievable with a new contouring atlas. MATERIALS/METHODS: The atlas included: medial and lateral pterygoids (MP, LP), masseter (M) and temporalis (T) muscles, and the temporo-mandibular joint (TMJ). Seven clinicians delineated five paired structures on CT scans from 5 patients without the atlas. After ?5?weeks, contouring was repeated using the atlas. Using contours generated by the clinicians on the same 5 CT scans as reference, dice similarity coefficient (DSC), mean distance-to-agreement (DTA) and centre of mass (COM) difference were compared with and without the atlas. Comparison was also performed split by training grade. Mean and standard deviation (SD) values were measured. RESULTS: The atlas reduced interobserver variability for all structures. Mean DTA significantly improved for MP (p?=?0.01), M (p?<?0.01), T (p?<?0.01) and TMJ (p?<?0.01). Mean DTA improved using the atlas for the trainees across all muscles, with the largest reduction in variability observed for the T (4.3?±?7.1 v 1.2?±?0.4?mm, p?=?0.06) and TMJ (2.1?±?0.7 v 0.8?±?0.3?mm, p?<?0.01). Distance between the COM and interobserver variability reduced in all directions for MP and T. CONCLUSION: A new atlas for contouring masticatory muscles during radiotherapy planning for head and neck cancer reduces interobserver variability and could be used as an educational tool.
    Citation
    Hague C, Beasley W, Dixon L, Gaito S, Garcez K, Green A, et al. Use of a novel atlas for muscles of mastication to reduce inter observer variability in head and neck radiotherapy contouring. Radiother Oncol. 2018 Nov 9.
    Journal
    Radiotherapy and Oncology
    URI
    http://hdl.handle.net/10541/621409
    DOI
    10.1016/j.radonc.2018.10.030
    PubMed ID
    30420234
    Additional Links
    https://dx.doi.org/10.1016/j.radonc.2018.10.030
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.radonc.2018.10.030
    Scopus Count
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