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Published on: February 23, 2024
Prostate positioning using cone-beam computer tomography based on manual soft-tissue registration: interobserver
B A Jereczek-Fossa1, C Pobbiati, L Santoro
1Department of Radiation Oncology, European Institute of Oncology, via Ripamonti 435, 20141, Milan, Italy, barbara.jereczek@ieo.it.
Summary
Radiation therapists (RTTs) show agreement comparable to radiation oncologists in cone-beam computed tomography (CBCT) for prostate cancer radiotherapy setup verification. This finding supports quality assurance and competency optimization in image-guided radiotherapy (IGRT).
Area of Science:
- Medical Physics
- Radiation Oncology
- Radiotherapy Technology
Background:
- Accurate patient positioning is critical for effective radiotherapy, particularly in prostate cancer treatment.
- Cone-beam computed tomography (CBCT) is increasingly used for image-guided radiotherapy (IGRT) setup verification.
- Interobserver agreement in interpreting CBCT data is essential for consistent and reliable radiotherapy delivery.
Purpose of the Study:
- To evaluate the interobserver agreement between radiation oncologists and radiation therapy technologists (RTTs).
- To assess the reliability of on- and off-line CBCT protocols for prostate cancer radiotherapy setup verification.
- To compare the interpretation of CBCT data by different healthcare professionals.
Main Methods:
- Four observers (one radiation oncologist, three RTTs) independently reviewed CBCT data from six prostate cancer patients.
- Data were analyzed using both off-line review and on-line CBCT positioning with manual soft-tissue registration.
- Interobserver agreement was quantified using weighted Cohen's kappa statistics.
Main Results:
- A total of 152 CBCT procedures were analyzed.
- Satisfactory interobserver agreement (weighted kappa >0.6) was observed in 10 out of 16 comparisons.
- Moderate agreement (0.41-0.60) was found in the remaining six comparisons, indicating good overall consistency.
Conclusions:
- Interpretation of CBCT for radiotherapy setup by RTTs is comparable to that of radiation oncologists.
- The findings support the use of RTTs in CBCT interpretation for quality assurance and competency optimization in IGRT.
- Further studies with larger sample sizes are recommended to validate these findings and assess impact on high-precision IGRT.
