NRG Oncology Updated International Consensus Atlas on Pelvic Lymph Node Volumes for Intact and Postoperative Prostate Cancer

In 2009, the Radiation Therapy Oncology Group (RTOG) genitourinary members published a consensus atlas for contouring prostate pelvic nodal clinical target volumes (CTVs). Data have emerged further informing nodal recurrence patterns. The objective of this study is to provide an updated prostate pel...

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Published inInternational journal of radiation oncology, biology, physics Vol. 109; no. 1; pp. 174 - 185
Main Authors Hall, William A., Paulson, Eric, Davis, Brian J., Spratt, Daniel E., Morgan, Todd M., Dearnaley, David, Tree, Alison C., Efstathiou, Jason A., Harisinghani, Mukesh, Jani, Ashesh B., Buyyounouski, Mark K., Pisansky, Thomas M., Tran, Phuoc T., Karnes, R. Jeffrey, Chen, Ronald C., Cury, Fabio L., Michalski, Jeff M., Rosenthal, Seth A., Koontz, Bridget F., Wong, Anthony C., Nguyen, Paul L., Hope, Thomas A., Feng, Felix, Sandler, Howard M., Lawton, Colleen A.F.
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 01.01.2021
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Abstract In 2009, the Radiation Therapy Oncology Group (RTOG) genitourinary members published a consensus atlas for contouring prostate pelvic nodal clinical target volumes (CTVs). Data have emerged further informing nodal recurrence patterns. The objective of this study is to provide an updated prostate pelvic nodal consensus atlas. A literature review was performed abstracting data on nodal recurrence patterns. Data were presented to a panel of international experts, including radiation oncologists, radiologists, and urologists. After data review, participants contoured nodal CTVs on 3 cases: postoperative, intact node positive, and intact node negative. Radiation oncologist contours were analyzed qualitatively using count maps, which provided a visual assessment of controversial regions, and quantitatively analyzed using Sorensen-Dice similarity coefficients and Hausdorff distances compared with the 2009 RTOG atlas. Diagnostic radiologists generated a reference table outlining considerations for determining clinical node positivity. Eighteen radiation oncologists’ contours (54 CTVs) were included. Two urologists’ volumes were examined in a separate analysis. The mean CTV for the postoperative case was 302 cm3, intact node positive case was 409 cm3, and intact node negative case was 342 cm3. Compared with the original RTOG consensus, the mean Sorensen-Dice similarity coefficient for the postoperative case was 0.63 (standard deviation [SD] 0.13), the intact node positive case was 0.68 (SD 0.13), and the intact node negative case was 0.66 (SD 0.18). The mean Hausdorff distance (in cm) for the postoperative case was 0.24 (SD 0.13), the intact node positive case was 0.23 (SD 0.09), and intact node negative case was 0.33 (SD 0.24). Four regions of CTV controversy were identified, and consensus for each of these areas was reached. Discordance with the 2009 RTOG consensus atlas was seen in a group of experienced NRG Oncology and international genitourinary radiation oncologists. To address areas of variability and account for new data, an updated NRG Oncology consensus contour atlas was developed.
AbstractList In 2009, the Radiation Therapy Oncology Group (RTOG) genitourinary members published a consensus atlas for contouring prostate pelvic nodal clinical target volumes (CTVs). Data have emerged further informing nodal recurrence patterns. The objective of this study is to provide an updated prostate pelvic nodal consensus atlas. A literature review was performed abstracting data on nodal recurrence patterns. Data were presented to a panel of international experts, including radiation oncologists, radiologists, and urologists. After data review, participants contoured nodal CTVs on 3 cases: postoperative, intact node positive, and intact node negative. Radiation oncologist contours were analyzed qualitatively using count maps, which provided a visual assessment of controversial regions, and quantitatively analyzed using Sorensen-Dice similarity coefficients and Hausdorff distances compared with the 2009 RTOG atlas. Diagnostic radiologists generated a reference table outlining considerations for determining clinical node positivity. Eighteen radiation oncologists' contours (54 CTVs) were included. Two urologists' volumes were examined in a separate analysis. The mean CTV for the postoperative case was 302 cm , intact node positive case was 409 cm , and intact node negative case was 342 cm . Compared with the original RTOG consensus, the mean Sorensen-Dice similarity coefficient for the postoperative case was 0.63 (standard deviation [SD] 0.13), the intact node positive case was 0.68 (SD 0.13), and the intact node negative case was 0.66 (SD 0.18). The mean Hausdorff distance (in cm) for the postoperative case was 0.24 (SD 0.13), the intact node positive case was 0.23 (SD 0.09), and intact node negative case was 0.33 (SD 0.24). Four regions of CTV controversy were identified, and consensus for each of these areas was reached. Discordance with the 2009 RTOG consensus atlas was seen in a group of experienced NRG Oncology and international genitourinary radiation oncologists. To address areas of variability and account for new data, an updated NRG Oncology consensus contour atlas was developed.
In 2009, the Radiation Therapy Oncology Group (RTOG) genitourinary members published a consensus atlas for contouring prostate pelvic nodal clinical target volumes (CTVs). Data have emerged further informing nodal recurrence patterns. The objective of this study is to provide an updated prostate pelvic nodal consensus atlas. A literature review was performed abstracting data on nodal recurrence patterns. Data were presented to a panel of international experts, including radiation oncologists, radiologists, and urologists. After data review, participants contoured nodal CTVs on 3 cases: postoperative, intact node positive, and intact node negative. Radiation oncologist contours were analyzed qualitatively using count maps, which provided a visual assessment of controversial regions, and quantitatively analyzed using Sorensen-Dice similarity coefficients and Hausdorff distances compared with the 2009 RTOG atlas. Diagnostic radiologists generated a reference table outlining considerations for determining clinical node positivity. Eighteen radiation oncologists’ contours (54 CTVs) were included. Two urologists’ volumes were examined in a separate analysis. The mean CTV for the postoperative case was 302 cm3, intact node positive case was 409 cm3, and intact node negative case was 342 cm3. Compared with the original RTOG consensus, the mean Sorensen-Dice similarity coefficient for the postoperative case was 0.63 (standard deviation [SD] 0.13), the intact node positive case was 0.68 (SD 0.13), and the intact node negative case was 0.66 (SD 0.18). The mean Hausdorff distance (in cm) for the postoperative case was 0.24 (SD 0.13), the intact node positive case was 0.23 (SD 0.09), and intact node negative case was 0.33 (SD 0.24). Four regions of CTV controversy were identified, and consensus for each of these areas was reached. Discordance with the 2009 RTOG consensus atlas was seen in a group of experienced NRG Oncology and international genitourinary radiation oncologists. To address areas of variability and account for new data, an updated NRG Oncology consensus contour atlas was developed.
In 2009, the Radiation Therapy Oncology Group (RTOG) genitourinary members published a consensus atlas for contouring prostate pelvic nodal clinical target volumes (CTVs). Data have emerged further informing nodal recurrence patterns. The objective of this study is to provide an updated prostate pelvic nodal consensus atlas.
In 2009, the Radiation Therapy Oncology Group (RTOG) genitourinary members published a consensus atlas for contouring prostate pelvic nodal clinical target volumes (CTVs). Data have emerged further informing nodal recurrence patterns. The objective of this study is to provide an updated prostate pelvic nodal consensus atlas.PURPOSEIn 2009, the Radiation Therapy Oncology Group (RTOG) genitourinary members published a consensus atlas for contouring prostate pelvic nodal clinical target volumes (CTVs). Data have emerged further informing nodal recurrence patterns. The objective of this study is to provide an updated prostate pelvic nodal consensus atlas.A literature review was performed abstracting data on nodal recurrence patterns. Data were presented to a panel of international experts, including radiation oncologists, radiologists, and urologists. After data review, participants contoured nodal CTVs on 3 cases: postoperative, intact node positive, and intact node negative. Radiation oncologist contours were analyzed qualitatively using count maps, which provided a visual assessment of controversial regions, and quantitatively analyzed using Sorensen-Dice similarity coefficients and Hausdorff distances compared with the 2009 RTOG atlas. Diagnostic radiologists generated a reference table outlining considerations for determining clinical node positivity.METHODS AND MATERIALSA literature review was performed abstracting data on nodal recurrence patterns. Data were presented to a panel of international experts, including radiation oncologists, radiologists, and urologists. After data review, participants contoured nodal CTVs on 3 cases: postoperative, intact node positive, and intact node negative. Radiation oncologist contours were analyzed qualitatively using count maps, which provided a visual assessment of controversial regions, and quantitatively analyzed using Sorensen-Dice similarity coefficients and Hausdorff distances compared with the 2009 RTOG atlas. Diagnostic radiologists generated a reference table outlining considerations for determining clinical node positivity.Eighteen radiation oncologists' contours (54 CTVs) were included. Two urologists' volumes were examined in a separate analysis. The mean CTV for the postoperative case was 302 cm3, intact node positive case was 409 cm3, and intact node negative case was 342 cm3. Compared with the original RTOG consensus, the mean Sorensen-Dice similarity coefficient for the postoperative case was 0.63 (standard deviation [SD] 0.13), the intact node positive case was 0.68 (SD 0.13), and the intact node negative case was 0.66 (SD 0.18). The mean Hausdorff distance (in cm) for the postoperative case was 0.24 (SD 0.13), the intact node positive case was 0.23 (SD 0.09), and intact node negative case was 0.33 (SD 0.24). Four regions of CTV controversy were identified, and consensus for each of these areas was reached.RESULTSEighteen radiation oncologists' contours (54 CTVs) were included. Two urologists' volumes were examined in a separate analysis. The mean CTV for the postoperative case was 302 cm3, intact node positive case was 409 cm3, and intact node negative case was 342 cm3. Compared with the original RTOG consensus, the mean Sorensen-Dice similarity coefficient for the postoperative case was 0.63 (standard deviation [SD] 0.13), the intact node positive case was 0.68 (SD 0.13), and the intact node negative case was 0.66 (SD 0.18). The mean Hausdorff distance (in cm) for the postoperative case was 0.24 (SD 0.13), the intact node positive case was 0.23 (SD 0.09), and intact node negative case was 0.33 (SD 0.24). Four regions of CTV controversy were identified, and consensus for each of these areas was reached.Discordance with the 2009 RTOG consensus atlas was seen in a group of experienced NRG Oncology and international genitourinary radiation oncologists. To address areas of variability and account for new data, an updated NRG Oncology consensus contour atlas was developed.CONCLUSIONSDiscordance with the 2009 RTOG consensus atlas was seen in a group of experienced NRG Oncology and international genitourinary radiation oncologists. To address areas of variability and account for new data, an updated NRG Oncology consensus contour atlas was developed.
Author Tree, Alison C.
Michalski, Jeff M.
Efstathiou, Jason A.
Karnes, R. Jeffrey
Hall, William A.
Harisinghani, Mukesh
Paulson, Eric
Sandler, Howard M.
Buyyounouski, Mark K.
Tran, Phuoc T.
Chen, Ronald C.
Feng, Felix
Jani, Ashesh B.
Hope, Thomas A.
Koontz, Bridget F.
Morgan, Todd M.
Cury, Fabio L.
Davis, Brian J.
Spratt, Daniel E.
Wong, Anthony C.
Lawton, Colleen A.F.
Dearnaley, David
Pisansky, Thomas M.
Rosenthal, Seth A.
Nguyen, Paul L.
AuthorAffiliation Department of Radiation Oncology, University of Kansas, Kansas City, Kansas
Department of Radiation Oncology, McGill University, Montreal, Canada
Department of Radiation Oncology, Washington University, St. Louis, Missouri
Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts
Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts
Department of Urology, Mayo Clinic, Rochester, Minnesota
Mayo Clinic, Department of Radiation Oncology, Rochester, Minnesota
Department of Radiation Oncology, Emory University, Atlanta, Georgia
Department of Radiation Oncology, Sutter Medical Group, Roseville, California
Department of Urology, University of Michigan, Ann Arbor, Michigan
Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California
Department of Radiation Oncology, Johns Hopkins, Baltimore, Maryland
Department of Radiation Oncology, Stanford University, Stanford, California
Department of Radiation O
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– name: Department of Urology, Mayo Clinic, Rochester, Minnesota
– name: Department of Radiation Oncology, McGill University, Montreal, Canada
– name: Department of Radiation Oncology, Duke Cancer Institute, Durham, North Carolina
– name: Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts
– name: Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/32861817$$D View this record in MEDLINE/PubMed
https://www.osti.gov/biblio/23198711$$D View this record in Osti.gov
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Snippet In 2009, the Radiation Therapy Oncology Group (RTOG) genitourinary members published a consensus atlas for contouring prostate pelvic nodal clinical target...
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StartPage 174
SubjectTerms Consensus
Humans
Internationality
LYMPH NODES
Lymph Nodes - pathology
Male
NEOPLASMS
Oncologists - statistics & numerical data
Organ Size
Pelvis
PROSTATE
Prostatic Neoplasms - pathology
Prostatic Neoplasms - surgery
RADIOLOGY AND NUCLEAR MEDICINE
RADIOTHERAPY
Title NRG Oncology Updated International Consensus Atlas on Pelvic Lymph Node Volumes for Intact and Postoperative Prostate Cancer
URI https://www.clinicalkey.com/#!/content/1-s2.0-S0360301620341249
https://dx.doi.org/10.1016/j.ijrobp.2020.08.034
https://www.ncbi.nlm.nih.gov/pubmed/32861817
https://www.proquest.com/docview/2438993396
https://www.osti.gov/biblio/23198711
https://pubmed.ncbi.nlm.nih.gov/PMC7736505
Volume 109
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