Contouring of prostate tumors on multiparametric MRI: Evaluation of clinical delineations in a multicenter radiotherapy trial
van Schie, Marcel A; Dinh, Cuong V; Houdt, Petra J van; Pos, Floris J; Heijmink, Stijn W T J P; Kerkmeijer, Linda G W; Kotte, Alexis N T J; Oyen, Raymond; Haustermans, Karin; van der Heide, Uulke A
(2018) Radiotherapy & Oncology, volume 128, issue 2, pp. 321 - 326
(Article)
Abstract
PURPOSE: To date no guidelines are available for contouring prostate cancer inside the gland, as visible on multiparametric (mp-) MRI. We assessed inter-institutional differences in interpretation of mp-MRI in the multicenter phase III FLAME trial. METHODS: We analyzed clinical delineations on mp-MRI and clinical characteristics from 260 patients across three
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institutes. We performed a logistic regression analysis to examine each institute's weighting of T2w, ADC and Ktrans intensity maps in the delineation of the cancer. As reviewing of all delineations by an expert panel is not feasible, we made a selection based on discrepancies between a published tumor probability (TP) model and each institute's clinical delineations using Areas Under the ROC Curve (AUC) analysis. RESULTS: Regression coefficients for the three institutes were -0.07, -0.27 and -0.11 for T2w, -1.96, -0.53 and -0.65 for ADC and 0.15, 0.20 and 0.62 for Ktrans, with significant differences between institutes for ADC and Ktrans. AUC analysis showed median AUC values of 0.92, 0.80 and 0.79. Five patients with lowest AUC values were reviewed by a uroradiologist. CONCLUSION: Regression coefficients revealed considerably different interpretations of mp-MRI in tumor contouring between institutes and demonstrated the need for contouring guidelines. Based on AUC values outlying delineations could efficiently be identified for review.
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Keywords: Aged, Aged, 80 and over, Area Under Curve, Humans, Magnetic Resonance Imaging/methods, Male, Middle Aged, Neoplasm Grading, Prostatic Neoplasms/pathology, ROC Curve, Tumor delineation, Multiparametric MRI, FLAME, Multicenter trial, Prostate cancer, Hematology, Oncology, Radiology Nuclear Medicine and imaging, Research Support, Non-U.S. Gov't, Randomized Controlled Trial, Multicenter Study, Clinical Trial, Phase III, Journal Article
ISSN: 0167-8140
Publisher: Elsevier Ireland Ltd
Note: Copyright © 2018 Elsevier B.V. All rights reserved.
(Peer reviewed)