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Assessment and improvement of radiation oncology trainee contouring ability utilizing consensus‐based penalty metrics
Author(s) -
Hallock Abhirami,
Bauman Glenn,
Read Nancy,
D'Souza David,
Perera Francisco,
Aivas Inge,
Best Lara,
Cao Jeffrey,
Louie Alexander V.,
Wiebe Ericka,
Sexton Tracy,
Gaede Stewart,
Battista Jerry,
Rodrigues George
Publication year - 2012
Publication title -
journal of medical imaging and radiation oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.31
H-Index - 43
eISSN - 1754-9485
pISSN - 1754-9477
DOI - 10.1111/j.1754-9485.2012.02440.x
Subject(s) - contouring , medicine , metric (unit) , medical physics , quality assurance , radiation oncology , radiation therapy , computer science , radiology , operations management , pathology , computer graphics (images) , economics , external quality assessment
The objective of this study was to develop and assess the feasibility of utilizing consensus‐based penalty metrics for the purpose of critical structure and organ at risk ( OAR ) contouring quality assurance and improvement. Methods A D elphi study was conducted to obtain consensus on contouring penalty metrics to assess trainee‐generated OAR contours. Voxel‐based penalty metric equations were used to score regions of discordance between trainee and expert contour sets. The utility of these penalty metric scores for objective feedback on contouring quality was assessed by using cases prepared for weekly radiation oncology radiation oncology trainee treatment planning rounds. Results In two D elphi rounds, six radiation oncology specialists reached agreement on clinical importance/impact and organ radiosensitivity as the two primary criteria for the creation of the C ritical S tructure I nter‐comparison of S egmentation ( CriSIS ) penalty functions. Linear/quadratic penalty scoring functions (for over‐ and under‐contouring) with one of four levels of severity (none, low, moderate and high) were assigned for each of 20 OAR s in order to generate a CriSIS score when new OAR contours are compared with reference/expert standards. Six cases (central nervous system, head and neck, gastrointestinal, genitourinary, gynaecological and thoracic) then were used to validate 18 OAR metrics through comparison of trainee and expert contour sets using the consensus derived CriSIS functions. For 14 OAR s, there was an improvement in CriSIS score post‐educational intervention. Conclusions The use of consensus‐based contouring penalty metrics to provide quantitative information for contouring improvement is feasible.