TY - JOUR
T1 - Refining critical structure contouring in STereotactic Arrhythmia Radioablation (STAR)
T2 - Benchmark results and consensus guidelines from the STOPSTORM.eu consortium
AU - Balgobind, Brian V.
AU - Visser, Jorrit
AU - Grehn, Melanie
AU - Marquard Knap, Marianne
AU - de Ruysscher, Dirk
AU - Levis, Mario
AU - Alcantara, Pino
AU - Boda-Heggemann, Judit
AU - Both, Marcus
AU - Cozzi, Salvatore
AU - Cvek, Jakub
AU - Dieleman, Edith M. T.
AU - Elicin, Olgun
AU - Giaj-Levra, Niccolò
AU - Jumeau, Raphaël
AU - Krug, David
AU - Algara López, Manuel
AU - Mayinger, Michael
AU - Mehrhof, Felix
AU - Miszczyk, Marcin
AU - Pérez-Calatayud, Maria José
AU - van der Pol, Luuk H. G.
AU - van der Toorn, Peter-Paul
AU - Vitolo, Viviana
AU - Postema, Pieter G.
AU - Pruvot, Etienne
AU - Verhoeff, Joost C.
AU - Blanck, Oliver
N1 - Funding Information: The authors would like to thank all members of the STOPSTORM.eu consortium (see https://stopstorm.eu/en/consortium ) and especially the credentialing and audit committee. We kindly thank the European Union’s Horizon-2020 research and innovation programme for funding this project under grant agreement No. 945119. Funding Information: PGP received funding from the Dutch Heart Foundation grant 03–003-2021-T061. Funding Information: This project has received funding from the European Union's Horizon-2020 research and innovation programme under grant agreement No 945119. Publisher Copyright: © 2023 The Authors
PY - 2023/12/1
Y1 - 2023/12/1
N2 - 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.
AB - 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.
KW - Cardiac substructures
KW - Contouring benchmark
KW - Organs at risk (OAR)
KW - STereotactic Arrhythmia Radioablation (STAR)
KW - Stereotactic Body Radiotherapy (SBRT)
KW - Ventricular tachycardia (VT)
UR - http://www.scopus.com/inward/record.url?scp=85173793469&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.radonc.2023.109949
DO - https://doi.org/10.1016/j.radonc.2023.109949
M3 - Article
C2 - 37827279
SN - 0167-8140
VL - 189
JO - Radiotherapy and oncology
JF - Radiotherapy and oncology
M1 - 109949
ER -