TY - JOUR
T1 - Interobserver variability in target definition for stereotactic arrhythmia radioablation
AU - van der Ree, Martijn H
AU - Cuculich, Phillip S
AU - van Herk, Marcel
AU - Hugo, Geoffrey D
AU - Balt, Jippe C
AU - Bates, Matthew
AU - Ho, Gordon
AU - Pruvot, Etienne
AU - Herrera-Siklody, Claudia
AU - Hoeksema, Wiert F
AU - Lee, Justin
AU - Lloyd, Michael S
AU - Kemme, Michiel J B
AU - Sacher, Frederic
AU - Tixier, Romain
AU - Verhoeff, Joost J C
AU - Balgobind, Brian V
AU - Robinson, Clifford G
AU - Rasch, Coen R N
AU - Postema, Pieter G
N1 - Funding Information: Dutch Heart Foundation grant 03-003-2021-T061 to Postema. MR has been supported by the Foundation “De Drie Lichten” in The Netherlands. The study participants partly received funding from the EU-Horizon-2020 STOPSTORM consortium project (Grant Agreement Number 945119) for STAR related projects, but this study was not directly funded by the EU-Horizon-2020 grant. Publisher Copyright: 2023 van der Ree, Cuculich, van Herk, Hugo, Balt, Bates, Ho, Pruvot, Herrera-Siklody, Hoeksema, Lee, Lloyd, Kemme, Sacher, Tixier, Verhoeff, Balgobind, Robinson, Rasch and Postema.
PY - 2023
Y1 - 2023
N2 - BACKGROUND: Stereotactic arrhythmia radioablation (STAR) is a potential new therapy for patients with refractory ventricular tachycardia (VT). The arrhythmogenic substrate (target) is synthesized from clinical and electro-anatomical information. This study was designed to evaluate the baseline interobserver variability in target delineation for STAR.METHODS: Delineation software designed for research purposes was used. The study was split into three phases. Firstly, electrophysiologists delineated a well-defined structure in three patients (spinal canal). Secondly, observers delineated the VT-target in three patients based on case descriptions. To evaluate baseline performance, a basic workflow approach was used, no advanced techniques were allowed. Thirdly, observers delineated three predefined segments from the 17-segment model. Interobserver variability was evaluated by assessing volumes, variation in distance to the median volume expressed by the root-mean-square of the standard deviation (RMS-SD) over the target volume, and the Dice-coefficient.RESULTS: Ten electrophysiologists completed the study. For the first phase interobserver variability was low as indicated by low variation in distance to the median volume (RMS-SD range: 0.02-0.02 cm) and high Dice-coefficients (mean: 0.97 ± 0.01). In the second phase distance to the median volume was large (RMS-SD range: 0.52-1.02 cm) and the Dice-coefficients low (mean: 0.40 ± 0.15). In the third phase, similar results were observed (RMS-SD range: 0.51-1.55 cm, Dice-coefficient mean: 0.31 ± 0.21).CONCLUSIONS: Interobserver variability is high for manual delineation of the VT-target and ventricular segments. This evaluation of the baseline observer variation shows that there is a need for methods and tools to improve variability and allows for future comparison of interventions aiming to reduce observer variation, for STAR but possibly also for catheter ablation.
AB - BACKGROUND: Stereotactic arrhythmia radioablation (STAR) is a potential new therapy for patients with refractory ventricular tachycardia (VT). The arrhythmogenic substrate (target) is synthesized from clinical and electro-anatomical information. This study was designed to evaluate the baseline interobserver variability in target delineation for STAR.METHODS: Delineation software designed for research purposes was used. The study was split into three phases. Firstly, electrophysiologists delineated a well-defined structure in three patients (spinal canal). Secondly, observers delineated the VT-target in three patients based on case descriptions. To evaluate baseline performance, a basic workflow approach was used, no advanced techniques were allowed. Thirdly, observers delineated three predefined segments from the 17-segment model. Interobserver variability was evaluated by assessing volumes, variation in distance to the median volume expressed by the root-mean-square of the standard deviation (RMS-SD) over the target volume, and the Dice-coefficient.RESULTS: Ten electrophysiologists completed the study. For the first phase interobserver variability was low as indicated by low variation in distance to the median volume (RMS-SD range: 0.02-0.02 cm) and high Dice-coefficients (mean: 0.97 ± 0.01). In the second phase distance to the median volume was large (RMS-SD range: 0.52-1.02 cm) and the Dice-coefficients low (mean: 0.40 ± 0.15). In the third phase, similar results were observed (RMS-SD range: 0.51-1.55 cm, Dice-coefficient mean: 0.31 ± 0.21).CONCLUSIONS: Interobserver variability is high for manual delineation of the VT-target and ventricular segments. This evaluation of the baseline observer variation shows that there is a need for methods and tools to improve variability and allows for future comparison of interventions aiming to reduce observer variation, for STAR but possibly also for catheter ablation.
KW - cardiac radioablation
KW - interobserver variability
KW - stereotactic arrhythmia radioablation
KW - stereotactic arrhythmia radiotherapy
KW - ventricular tachycardia
UR - http://www.scopus.com/inward/record.url?scp=85173731239&partnerID=8YFLogxK
U2 - https://doi.org/10.3389/fcvm.2023.1267800
DO - https://doi.org/10.3389/fcvm.2023.1267800
M3 - Article
C2 - 37799779
SN - 2297-055X
VL - 10
SP - 1267800
JO - Frontiers in cardiovascular medicine
JF - Frontiers in cardiovascular medicine
M1 - 1267800
ER -