Gkika, E., Tanadini-Lang, S., Kirste, S., Holzner, P. A., Neeff, H. P., Rischke, H. C., Reese, T., Lohaus, F., Duma, M. N., Dieckmann, K., Semrau, R., Stockinger, M., Imhoff, D., Kremers, N., Haefner, M. F., Andratschke, N., Nestle, U., Grosu, A. L., Guckenberger, M. and Brunner, T. B. (2017). Interobserver variability in target volume delineation of hepatocellular carcinoma. Strahlenther. Onkol., 193 (10). S. 823 - 831. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1439-099X

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Abstract

Background Definition of gross tumor volume (GTV) in hepatocellular carcinoma (HCC) requires dedicated imaging in multiple contrast medium phases. The aim of this study was to evaluate the interobserver agreement (IOA) in gross tumor delineation of HCC in a multicenter panel. Methods The analysis was performed within the Stereotactic Radiotherapy working group of the German Society for Radiation Oncology (DEGRO). The GTVs of three anonymized HCC cases were delineated by 16 physicians from nine centers using multiphasic CT scans. In the first case the tumor was well defined. The second patient had multifocal HCC (one conglomerate and one peripheral tumor) and was previously treated with transarterial chemoembolization (TACE). The peripheral lesion was adjacent to the previous TACE site. The last patient had an extensive HCC with a portal vein thrombosis (PVT) and an inhomogeneous liver parenchyma due to cirrhosis. The IOA was evaluated according to Landis and Koch. Results The IOA for the first case was excellent (kappa: 0.85); for the second case moderate (kappa: 0.48) for the peripheral tumor and substantial (kappa: 0.73) for the conglomerate. In the case of the peripheral tumor the inconsistency is most likely explained by the necrotic tumor cavity after TACE caudal to the viable tumor. In the last case the IOA was fair, with a kappa of 0.34, with significant heterogeneity concerning the borders of the tumor and the PVT. Conclusion The IOA was very good among the cases were the tumor was well defined. In complex cases, where the tumor did not show the typical characteristics, or in cases with Lipiodol (Guerbet, Paris, France) deposits, IOA agreement was compromised.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Gkika, E.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tanadini-Lang, S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kirste, S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Holzner, P. A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Neeff, H. P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rischke, H. C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Reese, T.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lohaus, F.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Duma, M. N.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dieckmann, K.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Semrau, R.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Stockinger, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Imhoff, D.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kremers, N.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Haefner, M. F.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Andratschke, N.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nestle, U.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Grosu, A. L.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Guckenberger, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Brunner, T. B.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-216010
DOI: 10.1007/s00066-017-1177-y
Journal or Publication Title: Strahlenther. Onkol.
Volume: 193
Number: 10
Page Range: S. 823 - 831
Date: 2017
Publisher: SPRINGER HEIDELBERG
Place of Publication: HEIDELBERG
ISSN: 1439-099X
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
STEREOTACTIC BODY RADIOTHERAPY; CLINICAL-PRACTICE GUIDELINES; LIVER-TUMORS; METAANALYSIS; AGREEMENT; DIAGNOSISMultiple languages
Oncology; Radiology, Nuclear Medicine & Medical ImagingMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/21601

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