The effect of dental artifacts, contrast media, and experience on interobserver contouring variations in head and neck anatomy

Jennifer C. O'Daniel, David I. Rosenthal, Adam S. Garden, Jerry L. Barker, Anesa Ahamad, K. Kian Ang, Joshua A. Asper, Angel I. Blanco, Renaud De Crevoisier, F. Christopher Holsinger, Chirag B. Patel, David Schwartz, He Wang, Lei Dong

Research output: Contribution to journalArticle

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Abstract

OBJECTIVES: To investigate interobserver variability in the delineation of head-and-neck (H&N) anatomic structures on CT images, including the effects of image artifacts and observer experience. METHODS: Nine observers (7 radiation oncologists, 1 surgeon, and 1 physician assistant) with varying levels of H&N delineation experience independently contoured H&N gross tumor volumes and critical structures on radiation therapy treatment planning CT images alongside reference diagnostic CT images for 4 patients with oropharynx cancer. Image artifacts from dental fillings partially obstructed 3 images. Differences in the structure volumes, center-of-volume positions, and boundary positions (1 SD) were measured. In-house software created three-dimensional overlap distributions, including all observers. The effects of dental artifacts and observer experience on contouring precision were investigated, and the need for contrast media was assessed. RESULTS: In the absence of artifacts, all 9 participants achieved reasonable precision (1 SD ≤3 mm all boundaries). The structures obscured by dental image artifacts had larger variations when measured by the 3 metrics (1 SD = 8 mm cranial/caudal boundary). Experience improved the interobserver consistency of contouring for structures obscured by artifacts (1 SD = 2 mm cranial/caudal boundary). CONCLUSIONS: Interobserver contouring variability for anatomic H&N structures, specifically oropharyngeal gross tumor volumes and parotid glands, was acceptable in the absence of artifacts. Dental artifacts increased the contouring variability, but experienced participants achieved reasonable precision even with artifacts present. With a staging contrast CT image as a reference, delineation on a noncontrast treatment planning CT image can achieve acceptable precision.

Original languageEnglish (US)
Pages (from-to)191-198
Number of pages8
JournalAmerican Journal of Clinical Oncology: Cancer Clinical Trials
Volume30
Issue number2
DOIs
StatePublished - Apr 1 2007

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Observer Variation
Artifacts
Contrast Media
Anatomy
Tooth
Neck
Head
Tumor Burden
Oropharyngeal Neoplasms
Physician Assistants
Parotid Gland
Radiotherapy
Software

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

The effect of dental artifacts, contrast media, and experience on interobserver contouring variations in head and neck anatomy. / O'Daniel, Jennifer C.; Rosenthal, David I.; Garden, Adam S.; Barker, Jerry L.; Ahamad, Anesa; Ang, K. Kian; Asper, Joshua A.; Blanco, Angel I.; De Crevoisier, Renaud; Holsinger, F. Christopher; Patel, Chirag B.; Schwartz, David; Wang, He; Dong, Lei.

In: American Journal of Clinical Oncology: Cancer Clinical Trials, Vol. 30, No. 2, 01.04.2007, p. 191-198.

Research output: Contribution to journalArticle

O'Daniel, JC, Rosenthal, DI, Garden, AS, Barker, JL, Ahamad, A, Ang, KK, Asper, JA, Blanco, AI, De Crevoisier, R, Holsinger, FC, Patel, CB, Schwartz, D, Wang, H & Dong, L 2007, 'The effect of dental artifacts, contrast media, and experience on interobserver contouring variations in head and neck anatomy', American Journal of Clinical Oncology: Cancer Clinical Trials, vol. 30, no. 2, pp. 191-198. https://doi.org/10.1097/01.coc.0000256704.58956.45
O'Daniel, Jennifer C. ; Rosenthal, David I. ; Garden, Adam S. ; Barker, Jerry L. ; Ahamad, Anesa ; Ang, K. Kian ; Asper, Joshua A. ; Blanco, Angel I. ; De Crevoisier, Renaud ; Holsinger, F. Christopher ; Patel, Chirag B. ; Schwartz, David ; Wang, He ; Dong, Lei. / The effect of dental artifacts, contrast media, and experience on interobserver contouring variations in head and neck anatomy. In: American Journal of Clinical Oncology: Cancer Clinical Trials. 2007 ; Vol. 30, No. 2. pp. 191-198.
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abstract = "OBJECTIVES: To investigate interobserver variability in the delineation of head-and-neck (H&N) anatomic structures on CT images, including the effects of image artifacts and observer experience. METHODS: Nine observers (7 radiation oncologists, 1 surgeon, and 1 physician assistant) with varying levels of H&N delineation experience independently contoured H&N gross tumor volumes and critical structures on radiation therapy treatment planning CT images alongside reference diagnostic CT images for 4 patients with oropharynx cancer. Image artifacts from dental fillings partially obstructed 3 images. Differences in the structure volumes, center-of-volume positions, and boundary positions (1 SD) were measured. In-house software created three-dimensional overlap distributions, including all observers. The effects of dental artifacts and observer experience on contouring precision were investigated, and the need for contrast media was assessed. RESULTS: In the absence of artifacts, all 9 participants achieved reasonable precision (1 SD ≤3 mm all boundaries). The structures obscured by dental image artifacts had larger variations when measured by the 3 metrics (1 SD = 8 mm cranial/caudal boundary). Experience improved the interobserver consistency of contouring for structures obscured by artifacts (1 SD = 2 mm cranial/caudal boundary). CONCLUSIONS: Interobserver contouring variability for anatomic H&N structures, specifically oropharyngeal gross tumor volumes and parotid glands, was acceptable in the absence of artifacts. Dental artifacts increased the contouring variability, but experienced participants achieved reasonable precision even with artifacts present. With a staging contrast CT image as a reference, delineation on a noncontrast treatment planning CT image can achieve acceptable precision.",
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T1 - The effect of dental artifacts, contrast media, and experience on interobserver contouring variations in head and neck anatomy

AU - O'Daniel, Jennifer C.

AU - Rosenthal, David I.

AU - Garden, Adam S.

AU - Barker, Jerry L.

AU - Ahamad, Anesa

AU - Ang, K. Kian

AU - Asper, Joshua A.

AU - Blanco, Angel I.

AU - De Crevoisier, Renaud

AU - Holsinger, F. Christopher

AU - Patel, Chirag B.

AU - Schwartz, David

AU - Wang, He

AU - Dong, Lei

PY - 2007/4/1

Y1 - 2007/4/1

N2 - OBJECTIVES: To investigate interobserver variability in the delineation of head-and-neck (H&N) anatomic structures on CT images, including the effects of image artifacts and observer experience. METHODS: Nine observers (7 radiation oncologists, 1 surgeon, and 1 physician assistant) with varying levels of H&N delineation experience independently contoured H&N gross tumor volumes and critical structures on radiation therapy treatment planning CT images alongside reference diagnostic CT images for 4 patients with oropharynx cancer. Image artifacts from dental fillings partially obstructed 3 images. Differences in the structure volumes, center-of-volume positions, and boundary positions (1 SD) were measured. In-house software created three-dimensional overlap distributions, including all observers. The effects of dental artifacts and observer experience on contouring precision were investigated, and the need for contrast media was assessed. RESULTS: In the absence of artifacts, all 9 participants achieved reasonable precision (1 SD ≤3 mm all boundaries). The structures obscured by dental image artifacts had larger variations when measured by the 3 metrics (1 SD = 8 mm cranial/caudal boundary). Experience improved the interobserver consistency of contouring for structures obscured by artifacts (1 SD = 2 mm cranial/caudal boundary). CONCLUSIONS: Interobserver contouring variability for anatomic H&N structures, specifically oropharyngeal gross tumor volumes and parotid glands, was acceptable in the absence of artifacts. Dental artifacts increased the contouring variability, but experienced participants achieved reasonable precision even with artifacts present. With a staging contrast CT image as a reference, delineation on a noncontrast treatment planning CT image can achieve acceptable precision.

AB - OBJECTIVES: To investigate interobserver variability in the delineation of head-and-neck (H&N) anatomic structures on CT images, including the effects of image artifacts and observer experience. METHODS: Nine observers (7 radiation oncologists, 1 surgeon, and 1 physician assistant) with varying levels of H&N delineation experience independently contoured H&N gross tumor volumes and critical structures on radiation therapy treatment planning CT images alongside reference diagnostic CT images for 4 patients with oropharynx cancer. Image artifacts from dental fillings partially obstructed 3 images. Differences in the structure volumes, center-of-volume positions, and boundary positions (1 SD) were measured. In-house software created three-dimensional overlap distributions, including all observers. The effects of dental artifacts and observer experience on contouring precision were investigated, and the need for contrast media was assessed. RESULTS: In the absence of artifacts, all 9 participants achieved reasonable precision (1 SD ≤3 mm all boundaries). The structures obscured by dental image artifacts had larger variations when measured by the 3 metrics (1 SD = 8 mm cranial/caudal boundary). Experience improved the interobserver consistency of contouring for structures obscured by artifacts (1 SD = 2 mm cranial/caudal boundary). CONCLUSIONS: Interobserver contouring variability for anatomic H&N structures, specifically oropharyngeal gross tumor volumes and parotid glands, was acceptable in the absence of artifacts. Dental artifacts increased the contouring variability, but experienced participants achieved reasonable precision even with artifacts present. With a staging contrast CT image as a reference, delineation on a noncontrast treatment planning CT image can achieve acceptable precision.

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