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07.11.2018 | Original Article

Assessment of a guideline-based heart substructures delineation in left-sided breast cancer patients undergoing adjuvant radiotherapy

Quality assessment within a randomized phase III trial testing a cardioprotective treatment strategy (SAFE-2014)

verfasst von: Giulio Francolini, Isacco Desideri, Icro Meattini, Carlotta Becherini, Francesca Terziani, Emanuela Olmetto, Camilla Delli Paoli, Donato Pezzulla, Mauro Loi, Pierluigi Bonomo, Daniela Greto, Silvia Calusi, Marta Casati, Stefania Pallotta, Lorenzo Livi

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 1/2019

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Abstract

Background and purpose

In our institute, breast cancer patients undergoing adjuvant treatment are included in a protocol aimed to reduce cardiovascular morbidity (SAFE-2014, NCT2236806), assessing preclinical heart damage with heart speckle-tracking ultrasound. To develop a dose constraint related to subclinical heart damage, a reliable delineation of heart substructures based on a pre-existing guideline was made.

Patients and methods

Heart substructures of 16 left-sided breast cancer patients included in the SAFE protocol were delineated by five operators. For each substructure, a multi-contour delineation based on a majority vote algorithm (MCD) was created. A consensus-based delineation (CBD) was developed by an independent team of two blinded operators. Dice similarity coefficients (DSC) between volumes delineated by different operators and the MCD were collected and reported, as well as DSC between CBD and MCD.

Results

Mean DSCs between heart chambers delineated by each operator and the corresponding MCDs ranged between 0.78 and 0.96. Mean DSC between substructures delineated by all single operators and the corresponding MCD ranged between 0.84 and 0.94. Mean DSC between CBD and the corresponding MCD ranged from 0.89 to 0.97.

Conclusion

Results showed low inter-observer variability of heart substructure delineation. This constitutes an external validation of the contouring atlas used, allowing a reliable dosimetric assessment of these volumes within the SAFE-2014 trial.

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Titel: Assessment of a guideline-based heart substructures delineation in left-sided breast cancer patients undergoing adjuvant radiotherapy
Quality assessment within a randomized phase III trial testing a cardioprotective treatment strategy (SAFE-2014)
verfasst von: Giulio Francolini
Isacco Desideri
Icro Meattini
Carlotta Becherini
Francesca Terziani
Emanuela Olmetto
Camilla Delli Paoli
Donato Pezzulla
Mauro Loi
Pierluigi Bonomo
Daniela Greto
Silvia Calusi
Marta Casati
Stefania Pallotta
Lorenzo Livi
Publikationsdatum: 07.11.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: Strahlentherapie und Onkologie / Ausgabe 1/2019
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-018-1388-x

Springer Medizin

Assessment of a guideline-based heart substructures delineation in left-sided breast cancer patients undergoing adjuvant radiotherapy

Quality assessment within a randomized phase III trial testing a cardioprotective treatment strategy (SAFE-2014)