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Refining critical structure contouring in STereotactic Arrhythmia Radioablation (STAR): Benchmark results and consensus guidelines from the STOPSTORM.eu consortium

Background and purpose - In patients with recurrent ventricular tachycardia (VT), STereotactic Arrhythmia Radioablation (STAR) shows promising results. The STOPSTORM.eu consortium was established to investigate and harmonise STAR treatment in Europe. The primary goals of this benchmark study were to...

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Main Authors: Balgobind, Brian V. (Author) , Visser, Jorrit (Author) , Grehn, Melanie (Author) , Marquard Knap, Marianne (Author) , de Ruysscher, Dirk (Author) , Levis, Mario (Author) , Alcantara, Pino (Author) , Boda-Heggemann, Judit (Author) , Both, Marcus (Author) , Cozzi, Salvatore (Author) , Cvek, Jakub (Author) , Dieleman, Edith M. T. (Author) , Elicin, Olgun (Author) , Giaj-Levra, Niccolò (Author) , Jumeau, Raphaël (Author) , Krug, David (Author) , Algara López, Manuel (Author) , Mayinger, Michael (Author) , Mehrhof, Felix (Author) , Miszczyk, Marcin (Author) , Pérez-Calatayud, Maria José (Author) , van der Pol, Luuk H. G. (Author) , van der Toorn, Peter-Paul (Author) , Vitolo, Viviana (Author) , Postema, Pieter G. (Author) , Pruvot, Etienne (Author) , Verhoeff, Joost C. (Author) , Blanck, Oliver (Author)
Format: Article (Journal)
Language:English
Published: December 2023
In: Radiotherapy and oncology
Year: 2023, Volume: 189, Pages: 1-8
ISSN:1879-0887
DOI:10.1016/j.radonc.2023.109949
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.radonc.2023.109949
Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S0167814023898437
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Author Notes:Brian V. Balgobind, Jorrit Visser, Melanie Grehn, Marianne Marquard Knap, Dirk de Ruysscher, Mario Levis, Pino Alcantara, Judit Boda-Heggemann, Marcus Both, Salvatore Cozzi, Jakub Cvek, Edith M.T. Dieleman, Olgun Elicin, Niccolò Giaj-Levra, Raphaël Jumeau, David Krug, Manuel Algara López, Michael Mayinger, Felix Mehrhof, Marcin Miszczyk, Maria José Pérez-Calatayud, Luuk H.G. van der Pol, Peter-Paul van der Toorn, Viviana Vitolo, Pieter G. Postema, Etienne Pruvot, Joost C. Verhoeff, Oliver Blanck
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Summary:Background and purpose - In patients with recurrent ventricular tachycardia (VT), STereotactic Arrhythmia Radioablation (STAR) shows promising results. The STOPSTORM.eu consortium was established to investigate and harmonise STAR treatment in Europe. The primary goals of this benchmark study were to standardise contouring of organs at risk (OAR) for STAR, including detailed substructures of the heart, and accredit each participating centre. - Materials and Methods - Centres within the STOPSTORM.eu consortium were asked to delineate 31 OAR in three STAR cases. Delineation was reviewed by the consortium expert panel and after a dedicated workshop feedback and accreditation was provided to all participants. Further quantitative analysis was performed by calculating DICE similarity coefficients (DSC), median distance to agreement (MDA), and 95th percentile distance to agreement (HD95). - Results - Twenty centres participated in this study. Based on DSC, MDA and HD95, the delineations of well-known OAR in radiotherapy were similar, such as lungs (median DSC = 0.96, median MDA = 0.1 mm and median HD95 = 1.1 mm) and aorta (median DSC = 0.90, median MDA = 0.1 mm and median HD95 = 1.5 mm). Some centres did not include the gastro-oesophageal junction, leading to differences in stomach and oesophagus delineations. For cardiac substructures, such as chambers (median DSC = 0.83, median MDA = 0.2 mm and median HD95 = 0.5 mm), valves (median DSC = 0.16, median MDA = 4.6 mm and median HD95 = 16.0 mm), coronary arteries (median DSC = 0.4, median MDA = 0.7 mm and median HD95 = 8.3 mm) and the sinoatrial and atrioventricular nodes (median DSC = 0.29, median MDA = 4.4 mm and median HD95 = 11.4 mm), deviations between centres occurred more frequently. After the dedicated workshop all centres were accredited and contouring consensus guidelines for STAR were established. - Conclusion - This STOPSTORM multi-centre critical structure contouring benchmark study showed high agreement for standard radiotherapy OAR. However, for cardiac substructures larger disagreement in contouring occurred, which may have significant impact on STAR treatment planning and dosimetry evaluation. To standardize OAR contouring, consensus guidelines for critical structure contouring in STAR were established.
Item Description:Online verfügbar: 10. Oktober 2023, Artikelversion: 14. Oktober 2023
Gesehen am 11.04.2024
Physical Description:Online Resource
ISSN:1879-0887
DOI:10.1016/j.radonc.2023.109949

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