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Inter-observer variation in delineating the coronary arteries as organs at risk
Umea Univ, Dept Surg & Perioperat Sci, Surg, S-90187 Umea, Sweden.;Sundsvall Hosp, Dept Oncol, SE-85186 Sundsvall, Sweden..
Kings Coll London, Fac Life Sci & Med, London WC2R 2LS, England.;Reg Canc Ctr, Uppsala, Sweden..
Gavle Cent Hosp, Dept Oncol, Gavle, Sweden..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Experimental and Clinical Oncology.
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2017 (English)In: Radiotherapy and Oncology, ISSN 0167-8140, E-ISSN 1879-0887, Vol. 122, no 1, 72-78 p.Article in journal (Refereed) Published
Abstract [en]

Purpose: To determine the inter-observer variation in delineating the coronary arteries as organs at risk (OAR) in breast cancer (BC) radiotherapy (RT) and how this variation affects the estimated coronary artery radiation dose.

Method: Delineation of the left main and the left anterior descending coronary artery (LMCA and LAD), and the right coronary artery (RCA), by using the heart atlas by Feng et al., was performed by three radiation oncologists in 32 women who had received adjuvant RT for BC. Centres of the arteries were calculated and distances between artery centres were measured and the artery radiation doses were estimated. The intraclass correlation coefficient (ICC) was used to quantify the variability in doses.

Results: Along the extent of RCA, the median distance between centres of arteries varied from 2 to 9 mm with similar patterns over pairs of oncologists. For the LMCA-LAD the median distance varied from 1 to 4 mm. The estimated maximum radiation doses showed an ICC variation from 0.82 to 0.97.

Conclusion: The coronary arteries can be reliably identified and delineated as OARs in BC RT. The spatial variance is limited and the total variation in radiation dose is almost completely determined by the between patient variation.

Place, publisher, year, edition, pages
ELSEVIER IRELAND LTD , 2017. Vol. 122, no 1, 72-78 p.
Keyword [en]
Breast cancer radiotherapy, Coronary stenosis, Delineation, Inter-observer variation, Left anterior descending artery
National Category
Cancer and Oncology
Identifiers
URN: urn:nbn:se:uu:diva-319871DOI: 10.1016/j.radonc.2016.11.007ISI: 000395217900013PubMedID: 27866849OAI: oai:DiVA.org:uu-319871DiVA: diva2:1088659
Available from: 2017-04-13 Created: 2017-04-13 Last updated: 2017-04-13Bibliographically approved

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