Evidence map›Paper›PMID 39512305›Full record

ArticleTechnical innovations & patient support in radiation oncology2024

On the trail of CBCT-guided adaptive rectal boost radiotherapy, does daily delineation require a radiation oncologist?

Julien Pierrard, David Dechambre, Christel Abdel Massih, Sophie Cvilic, Ana Da Silva Chambel Roma, Pascale Henderickx, Sofie Heylen, Eleonore Longton, Romain Mony, Mohamed Amine Tenabene and 6 more

Abstract read
In one paragraph

Article in Technical innovations & patient support in radiation oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Julien PierrardUCLouvain, Institut de Recherche Experimentale et Clinique (IREC), Center of Molecular Imaging, Radiotherapy and Oncology (MIRO), Brussels, Belgium.
David DechambreDepartment of Radiation Oncology, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
Christel Abdel MassihDepartment of Radiation Oncology, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
Sophie CvilicDepartment of Radiation Oncology, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
Ana Da Silva Chambel RomaDepartment of Radiation Oncology, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
Pascale HenderickxDepartment of Radiation Oncology, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
Sofie HeylenDepartment of Radiation Oncology, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
Eleonore LongtonDepartment of Radiation Oncology, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
Romain MonyDepartment of Radiation Oncology, Centre Henri Becquerel, Rouen, France.
Mohamed Amine TenabeneDepartment of Radiation Oncology, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
Thaïs TisonDepartment of Radiation Oncology, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
Ad VandermeulenDepartment of Radiation Oncology, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
Loïc Vander VekenUCLouvain, Institut de Recherche Experimentale et Clinique (IREC), Center of Molecular Imaging, Radiotherapy and Oncology (MIRO), Brussels, Belgium.
Aniko Wale EtumeDepartment of Radiation Oncology, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
Anne-Emmanuella YeoDepartment of Radiation Oncology, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
Geneviève Van OoteghemUCLouvain, Institut de Recherche Experimentale et Clinique (IREC), Center of Molecular Imaging, Radiotherapy and Oncology (MIRO), Brussels, Belgium.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Dose-escalation radiotherapy for rectal tumours is increasingly considered as a non-operative approach, with online-adaptive radiotherapy (oART) supporting this approach by correcting inter-fraction tumour position errors. However, using cone-beam computed tomography (CBCT)-guided oART requires daily target volume delineation by different operators, leading to inter-operator delineation variability and potential dosimetric issues. This study aims to compare and quantify the inter-operator and inter-professional delineation variability of the rectal boost volume on CBCT, including volumes by an automatically delineated oART treatment planning system. Materials and methods: A rectal boost volume, defined as the primary tumour extended to the entire adjacent rectal wall, was delineated on 10 CBCTs from 5 patients by 15 operators: 4 expert radiation oncologists (ROs), 4 radiation therapists (RTTs) and 7 non-expert ROs. These contours were compared between the different professional groups. A comparison to the average volume of the group (ROs, RTTs, or non-expert ROs) with the lowest delineation variability was also performed for each individual volume including the volume automatically generated by an oART treatment planning system. Results: Delineation variability was the highest in the superior (range: 2.3-6.0 mm), and inferior (2.3-12.4 mm) directions, compared to the left (0.2-4.4 mm), right (0.3-2.0 mm), anterior (0.1-2.9 mm), and posterior (0.5-4.0 mm) directions. Non-expert ROs, RTTs, and automatic oART volume showed similar ranges of delineation errors when compared to the expert ROs' volume, which was chosen as reference volume since this professional group showed the lowest variability. Discussion: Expert ROs showed consistent results. Other professional groups exhibit similar variability, comparable to the automatic oART volume. Therefore, RTTs could safely perform the rectal boost delineation without non-expert ROs supervision in the absence of expert ROs during CBCT-based oART. Moreover, these findings provide quantitative data to compute accurate margins for the rectal boost planning target volume in a CBCT-guided oART workflow.

Indexed as

CBCT-guided radiotherapyDelineation variabilityRadiation TherapistsRectum boostRectum radiotherapy

Identifiers

PMID39512305
PMCPMC11541823

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.