ArticleRadiation oncology (London, England)2021
Heart atlas for retrospective cardiac dosimetry: a multi-institutional study on interobserver contouring variations and their dosimetric impact.
Article in Radiation oncology (London, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed, 9 citations in OpenAlex.
- AI-surrogate structure and dose correlation for left anterior descending artery in lung stereotactic body radiotherapy.Journal of applied clinical medical physics · 2026Article
- Performance of a Vendor System for Systematic Offline Adaptive Breast Helical Radiotherapy.Cancers · 2026Article
- Comparative analysis of artificial intelligence-based contouring of cardiac substructures on computed tomography scans for radiation therapy.Physics and imaging in radiation oncology · 2026Article
- Cardiac substructure delineation in radiation therapy - A state-of-the-art review.Journal of medical imaging and radiation oncology · 2024Review
- The influence of cardiac substructure dose on survival in a large lung cancer stereotactic radiotherapy cohort using a robust personalized contour analysis.Physics and imaging in radiation oncology · 2024Article
- Development of a comprehensive cardiac atlas on a 1.5 Tesla Magnetic Resonance Linear Accelerator.Physics and imaging in radiation oncology · 2023Article
- Accelerated Atherosclerosis and Cardiovascular Toxicity Induced by Radiotherapy in Breast Cancer.Life (Basel, Switzerland) · 2023Review
- Advances in automatic delineation of target volume and cardiac substructure in breast cancer radiotherapy (Review).Oncology letters · 2023Review
- A nested case-control study on radiation dose-response for cardiac events in breast cancer patients in Germany.Breast (Edinburgh, Scotland) · 2022Article
- Anatomy-dependent lung doses from 3D-conformal breast-cancer radiotherapy.Scientific reports · 2022Article
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Authors and funding
11 authors at 4 institutions in 1 country.
Funding
Abstract
purposeCardiac effects after breast cancer radiation therapy potentially affect more patients as survival improves. The heart's heterogeneous radiation exposure and composition of functional structures call for establishing individual relationships between structure dose and specific late effects. However, valid dosimetry requires reliable contouring which is challenging for small volumes based on older, lower-quality computed tomography imaging. We developed a heart atlas for robust heart contouring in retrospective epidemiologic studies. METHODS AND MATERIALS: The atlas defined the complete heart and geometric surrogate volumes for six cardiac structures: aortic valve, pulmonary valve, all deeper structures combined, myocardium, left anterior myocardium, and right anterior myocardium. We collected treatment planning records from 16 patients from 4 hospitals including dose calculations for 3D conformal tangential field radiation therapy for left-sided breast cancer. Six observers each contoured all patients. We assessed spatial contouring agreement and corresponding dosimetric variability.
resultsContouring agreement for the complete heart was high with a mean Jaccard similarity coefficient (JSC) of 89%, a volume coefficient of variation (CV) of 5.2%, and a mean dose CV of 4.2%. The left (right) anterior myocardium had acceptable agreement with 63% (58%) JSC, 9.8% (11.5%) volume CV, and 11.9% (8.0%) mean dose CV. Dosimetric agreement for the deep structures and aortic valve was good despite higher spatial variation. Low spatial agreement for the pulmonary valve translated to poor dosimetric agreement.
conclusionsFor the purpose of retrospective dosimetry based on older imaging, geometric surrogate volumes for cardiac organs at risk can yield better contouring agreement than anatomical definitions, but retain limitations for small structures like the pulmonary valve.
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