Assessment of a guideline-based heart substructures delineation in left-sided breast cancer patients undergoing adjuvant radiotherapy Quality assessment within a randomized phase III trial testing a cardioprotective treatment strategy (SAFE-2014)

Background and purpose In our institute, breast cancer patients undergoing adjuvant treatment are included in a protocol aimed to reduce cardiovascular morbidity (SAFE-2014, NCT2236806), assessing preclinical heart damage with heart speckle-tracking ultrasound. To develop a dose constraint related t...

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Published in:Strahlentherapie und Onkologie Vol. 195; no. 1; pp. 43 - 51
Main Authors: Francolini, Giulio, Desideri, Isacco, Meattini, Icro, Becherini, Carlotta, Terziani, Francesca, Olmetto, Emanuela, Delli Paoli, Camilla, Pezzulla, Donato, Loi, Mauro, Bonomo, Pierluigi, Greto, Daniela, Calusi, Silvia, Casati, Marta, Pallotta, Stefania, Livi, Lorenzo
Format: Journal Article
Language:English
Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.01.2019
Subjects:
Algorithms
Bisoprolol - administration & dosage
Cardiotonic Agents - administration & dosage
Chemotherapy, Adjuvant - methods
Combined Modality Therapy - methods
Drug Therapy, Combination
Echocardiography, Doppler - methods
Female
Guideline Adherence
Heart - drug effects
Heart - radiation effects
Humans
Medicine
Medicine & Public Health
Observer Variation
Oncology
Original Article
Quality Assurance, Health Care
Radiation Injuries - diagnostic imaging
Radiation Injuries - prevention & control
Radiometry - methods
Radiotherapy
Radiotherapy, Adjuvant - methods
Ramipril - administration & dosage
Reproducibility of Results
Unilateral Breast Neoplasms - drug therapy
Unilateral Breast Neoplasms - radiotherapy
Anthracyclines
Anthrazykline
Ramipril
Kardiovaskuläre Erkrankungen
Bisoprolol
Cardiovascular diseases
Trastuzumab
ISSN:0179-7158, 1439-099X, 1439-099X
Online Access:Get full text
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Summary:Background and purpose In our institute, breast cancer patients undergoing adjuvant treatment are included in a protocol aimed to reduce cardiovascular morbidity (SAFE-2014, NCT2236806), assessing preclinical heart damage with heart speckle-tracking ultrasound. To develop a dose constraint related to subclinical heart damage, a reliable delineation of heart substructures based on a pre-existing guideline was made. Patients and methods Heart substructures of 16 left-sided breast cancer patients included in the SAFE protocol were delineated by five operators. For each substructure, a multi-contour delineation based on a majority vote algorithm (MCD) was created. A consensus-based delineation (CBD) was developed by an independent team of two blinded operators. Dice similarity coefficients (DSC) between volumes delineated by different operators and the MCD were collected and reported, as well as DSC between CBD and MCD. Results Mean DSCs between heart chambers delineated by each operator and the corresponding MCDs ranged between 0.78 and 0.96. Mean DSC between substructures delineated by all single operators and the corresponding MCD ranged between 0.84 and 0.94. Mean DSC between CBD and the corresponding MCD ranged from 0.89 to 0.97. Conclusion Results showed low inter-observer variability of heart substructure delineation. This constitutes an external validation of the contouring atlas used, allowing a reliable dosimetric assessment of these volumes within the SAFE-2014 trial.
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ISSN:0179-7158
1439-099X
1439-099X
DOI:10.1007/s00066-018-1388-x