Contouring variation affects estimates of normal tissue complication probability for breast fibrosis after radiotherapy
Background - Normal tissue complication probability (NTCP) models can be useful to estimate the risk of fibrosis after breast-conserving surgery (BCS) and radiotherapy (RT) to the breast. However, they are subject to uncertainties. We present the impact of contouring variation on the prediction of f...
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| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
December 2023
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| In: |
The breast
Year: 2023, Volume: 72, Pages: 1-9 |
| ISSN: | 1532-3080 |
| DOI: | 10.1016/j.breast.2023.103578 |
| Online Access: | Verlag, kostenfrei, Volltext: https://doi.org/10.1016/j.breast.2023.103578 Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S0960977623005520 
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| Author Notes: | Tanwiwat Jaikuna, Eliana Vasquez Osorio, David Azria, Jenny Chang-Claude, Maria Carmen De Santis, Sara Gutiérrez-Enríquez, Marcel van Herk, Peter Hoskin, Maarten Lambrecht, Zoe Lingard, Petra Seibold, Alejandro Seoane, Elena Sperk, R Paul Symonds, Christopher J. Talbot, Tiziana Rancati, Tim Rattay, Victoria Reyes, Barry S. Rosenstein, Dirk de Ruysscher, Ana Vega, Liv Veldeman, Adam Webb, Catharine M.L. West, Marianne C. Aznar |
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| 245 | 1 | 0 | |a Contouring variation affects estimates of normal tissue complication probability for breast fibrosis after radiotherapy |c Tanwiwat Jaikuna, Eliana Vasquez Osorio, David Azria, Jenny Chang-Claude, Maria Carmen De Santis, Sara Gutiérrez-Enríquez, Marcel van Herk, Peter Hoskin, Maarten Lambrecht, Zoe Lingard, Petra Seibold, Alejandro Seoane, Elena Sperk, R Paul Symonds, Christopher J. Talbot, Tiziana Rancati, Tim Rattay, Victoria Reyes, Barry S. Rosenstein, Dirk de Ruysscher, Ana Vega, Liv Veldeman, Adam Webb, Catharine M.L. West, Marianne C. Aznar |
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| 520 | |a Background - Normal tissue complication probability (NTCP) models can be useful to estimate the risk of fibrosis after breast-conserving surgery (BCS) and radiotherapy (RT) to the breast. However, they are subject to uncertainties. We present the impact of contouring variation on the prediction of fibrosis. - Materials and methods - 280 breast cancer patients treated BCS-RT were included. Nine Clinical Target Volume (CTV) contours were created for each patient: i) CTV_crop (reference), cropped 5 mm from the skin and ii) CTV_skin, uncropped and including the skin, iii) segmenting the 95% isodose (Iso95%) and iv) 3 different auto-contouring atlases generating uncropped and cropped contours (Atlas_skin/Atlas_crop). To illustrate the impact of contour variation on NTCP estimates, we applied two equations predicting fibrosis grade ≥ 2 at 5 years, based on Lyman-Kutcher-Burman (LKB) and Relative Seriality (RS) models, respectively, to each contour. Differences were evaluated using repeated-measures ANOVA. For completeness, the association between observed fibrosis events and NTCP estimates was also evaluated using logistic regression. - Results - There were minimal differences between contours when the same contouring approach was followed (cropped and uncropped). CTV_skin and Atlas_skin contours had lower NTCP estimates (−3.92%, IQR 4.00, p < 0.05) compared to CTV_crop. No significant difference was observed for Atlas_crop and Iso95% contours compared to CTV_crop. For the whole cohort, NTCP estimates varied between 5.3% and 49.5% (LKB) or 2.2% and 49.6% (RS) depending on the choice of contours. NTCP estimates for individual patients varied by up to a factor of 4. Estimates from “skin” contours showed higher agreement with observed events. - Conclusion - Contour variations can lead to significantly different NTCP estimates for breast fibrosis, highlighting the importance of standardising breast contours before developing and/or applying NTCP models. | ||
| 650 | 4 | |a Breast cancer | |
| 650 | 4 | |a Fibrosis | |
| 650 | 4 | |a Inter-observer variation | |
| 650 | 4 | |a Late effects | |
| 650 | 4 | |a NTCP modelling | |
| 650 | 4 | |a Radiotherapy | |
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| 700 | 1 | |a Azria, David |e VerfasserIn |4 aut | |
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| 700 | 1 | |a Symonds, R Paul |e VerfasserIn |4 aut | |
| 700 | 1 | |a Talbot, Christopher J. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Rancati, Tiziana |e VerfasserIn |4 aut | |
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