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Hamdy, F.C., Donovan, J.L., Lane, J., Mason, M., Metcalfe, C., Holding, P., Davis, M., Peters, T.J., Turner, E.L. and Martin, R.M. (2016) 10-Year Outcomes after Monitoring, Surgery, or Radiotherapy for Localized Prostate Cancer. The New England Journal of Medicine, 375, 1415-1424.
https://doi.org/10.1056/NEJMoa1606220

has been cited by the following article:

• TITLE: Dosimetric Effects Due to Inter-Observer Variability of Organ Contouring When Utilizing a Knowledge-Based Planning System for Prostate Cancer

  AUTHORS: Han Liu, Christopher Amaloo, Benjamin Sintay, David Wiant

  KEYWORDS: Inter-Observer Variability of Organ Contouring, Knowledge-Based Treat-ment Planning, Prostate Radiotherapy

  JOURNAL NAME: International Journal of Medical Physics, Clinical Engineering and Radiation Oncology, Vol.10 No.2, May 18, 2021

  ABSTRACT: Purpose: Radiotherapy is a widely accepted standard of care for early-stage prostate cancer, and it is believed that the plan quality and treatment outcome are associated with contour accuracy of both the target and organs-at-risk (OAR). The purposes of this study are to 1) assess geometric and dosimetric uncertainties due to inter-observer contour variabilities and 2) evaluate the effectiveness of geometric indicators to predict target dosimetry in prostate radiotherapy. Methods: Twenty prostate patients were selected for this retrospective study. Five experienced clinicians created unique structure sets containing prostate, seminal vesicles, bladder, and rectum for each patient. A fully automated script and knowledge-based planning routine were utilized to create standardized and unbiased plans that could be used to evaluate changes in isodose distributions due to inter-observer variability in structure segmentation. Plans were created on a “gold-standard” structure set, as well as on each of the user-defined structure sets. Results: Inter-observer variability of contours during structure segmentation was very low for clearly defined organs such as the bladder but increased for organs without well-defined borders (prostate, seminal vesicles, and rectum). For plans generated with the user-defined structure sets, strong/moderate correlations were observed between the geometric indicators for target structure agreement and target coverage for both low-risk and intermediate-risk patient groups, while OAR indicators showed no correlation to final dosimetry. Conclusions: Target delineation is crucial in order to maintain adequate dosimetric coverage regardless of the associated inter-observer uncertainties in OAR contours that had a limited impact upon final dosimetry.