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    Glioma consensus contouring recommendations from a MR-Linac International Consortium Research Group and evaluation of a CT-MRI and MRI-only workflow

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    Authors
    Tseng, C. L.
    Stewart, J.
    Whitfield, Gillian A
    Verhoeff, J. J. C.
    Bovi, J.
    Soliman, H.
    Chung, C.
    Myrehaug, S.
    Campbell, M.
    Atenafu, E. G.
    Heyn, C.
    Das, S.
    Perry, J.
    Ruschin, M.
    Sahgal, A.
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    Affiliation
    Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada
    Issue Date
    2020
    
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    Abstract
    Introduction: This study proposes contouring recommendations for radiation treatment planning target volumes and organs-at-risk (OARs) for both low grade and high grade gliomas. Methods: Ten cases consisting of 5 glioblastomas and 5 grade II or III gliomas, including their respective gross tumor volume (GTV), clinical target volume (CTV), and OARs were each contoured by 6 experienced neuro-radiation oncologists from 5 international institutions. Each case was first contoured using only MRI sequences (MRI-only), and then re-contoured with the addition of a fused planning CT (CT-MRI). The level of agreement among all contours was assessed using simultaneous truth and performance level estimation (STAPLE) with the kappa statistic and Dice similarity coefficient. Results: A high level of agreement was observed between the GTV and CTV contours in the MRI-only workflow with a mean kappa of 0.88 and 0.89, respectively, with no statistically significant differences compared to the CT-MRI workflow (p = 0.88 and p = 0.82 for GTV and CTV, respectively). Agreement in cochlea contours improved from a mean kappa of 0.39 to 0.41, to 0.69 to 0.71 with the addition of CT information (p < 0.0001 for both cochleae). Substantial to near perfect level of agreement was observed in all other contoured OARs with a mean kappa range of 0.60 to 0.90 in both MRI-only and CT-MRI workflows. Conclusions: Consensus contouring recommendations for low grade and high grade gliomas were established using the results from the consensus STAPLE contours, which will serve as a basis for further study and clinical trials by the MR-Linac Consortium. Keywords: Consensus contouring recommendations; Glioma; MR-linac; Organs-at-risk; Radiotherapy.
    Citation
    Tseng C-L, Stewart J, Whitfield G, Verhoeff JJC, Bovi J, Soliman H, et al. Glioma consensus contouring recommendations from a MR-Linac International Consortium Research Group and evaluation of a CT-MRI and MRI-only workflow. Journal of Neuro-Oncology. 2020.
    Journal
    Journal of Neuro-oncology
    URI
    http://hdl.handle.net/10541/623279
    DOI
    10.1007/s11060-020-03605-6
    PubMed ID
    32860571
    Additional Links
    https://dx.doi.org/10.1007/s11060-020-03605-6
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1007/s11060-020-03605-6
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