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Dosimetric Implications From Organ Segmentation

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Z Wu

Z Wu*, J Turian , J Chu , Rush University Medical Center, Chicago, IL


SU-E-T-134 Sunday 3:00PM - 6:00PM Room: Exhibit Hall

Purpose: To evaluate the dosimetric implications resulting from organ segmentation performed by different clinical experts

Methods: Twelve patients received SBRT treatment to thoracic region within the past year were selected for this study. Three physicians contoured a set of organs following RTOG guideline. DVHs of all contours were generated from the approved plans used for treatment, and were compared to those produced during planning. Most OARs were evaluated on their max dose, some, such as heart and chest wall, were also evaluated on metrics such as max dose to 4cc of volume, or 30Gy volume dose.

Results: In general, there is a greater dosimetric difference between the RTOG contour sets and clinical contour sets than among the three RTOG contour sets themselves for each patient. For example, there was no difference in esophagus max dose between the RTOG contour sets for ten patients. However, they showed an average of 2.3% higher max dose than the clinical contour set, with a standard deviation of 6.6%. The proximal bronchial tree (PBT) showed a similar behavior. The average difference of PBT max dose for seven patients is 0% between the three RTOG contour sets, with standard deviation of 1%. They showed an average of 16.1% higher max dose than the clinical contour set, with a standard deviation of 126%.

Conclusion: This study shows that using RTOG contouring standards improves segmentation consistency between different physicians; most of the contours examined showed less than 1% dose difference. When RTOG contour sets were compared to the clinical contour set, the differences are much more significant. Thus it is important to standardize contouring guidelines in radiation therapy treatment planning. This will reduce uncertainties in clinical outcome analysis and research studies.

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