Maria Jose Perez-Calatayud, Antonio Menéndez, Françoise Lliso, Vicente Carmona, Antonio Conde, Francisco Celada, Mariola Bernisz, Carlos Botella, Jose Perez-Calatayud
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引用次数: 0
摘要
这项工作的目的是评估前庭分裂瘤（VS）和危险器官（OAR）轮廓的观察者之间和观察者内部的差异，及其对体积调制弧治疗（VMAT）的剂量影响。四位临床医生对三个典型的 VS 病例进行了轮廓分析。VS 的协议容积指数 (AVI) 明显高于 OAR，因此 VS 的剂量覆盖范围相当稳固。在 OARs 中，最大的差异是脑干 dmax +1.02Gy，耳蜗 dmean +0.78Gy，三叉神经 dmax +1.05Gy。因此，决定所有立体定向放射手术（SRS）的 VS 划线以及所有基于框架的 SRS 轮廓都应始终由第二名医生审查。此外，在每天的同行评审会议上也会回顾性地介绍 VS 病例，以确保不断更新共识，并用于培训目的。
A single center, inter-observer evaluation of vestibular schwannoma stereotactic radiosurgery and its dosimetric impact.
The aim of this work was to evaluate the inter- and intra-observer variation in contouring vestibular schwannoma (VS) and the organs-at-risk (OAR), and its dosimetric impact in Volumetric Modulated Arc Therapy (VMAT). Three VS typical cases were contoured by four clinicians. The Agreement Volume Index (AVI) appeared to be notably higher in VS than in OARs, such that the dose coverage of VS is fairly robust. In OARs, the largest variation was +1.02Gy in dmax for the brainstem, +0.78Gy in dmean for the cochlea and +1.05Gy in dmax of the trigeminal nerve. Accordingly, it was decided that all VS delineations for stereotactic radiosurgery (SRS), and all frame-based SRS contouring in general, should always be reviewed by a second physician. In addition, the retrospective presentation of VS cases at daily peer review meetings has also been adopted to ensure that the consensus is constantly updated, as well as for training purposes.
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