Physician Body-Site Expertise and Stereotactic Radiosurgery/Stereotactic Body Radiation Therapy Rounds Review

Area of Science:

• Radiation Oncology
• Medical Physics
• Clinical Oncology

Background:

• Stereotactic body radiation therapy (SBRT) requires specialized contouring expertise for each anatomical site.
• Adequate peer review of SBRT plans necessitates reviewers with sufficient disease-site-specific knowledge.

Purpose of the Study:

• To investigate physician self-reported expertise in performing SBRT peer review across different body sites.
• To determine how reviewer expertise impacts the quality of SBRT peer review outcomes.

Main Methods:

• Analysis of 7 years of SBRT cases, including target and prescription data.
• Survey of physicians on their expertise level for reviewing SBRT cases by body site.
• Multivariable logistic regression and generalized estimating equations to assess the association between reviewer expertise, body site, and planning data changes.

Main Results:

• Reviewing physician experts were more likely to recommend changes to gross target volume and prescription compared to non-experts.
• Specific sites like brain, liver, spine, and stereotactic radiosurgery showed increased likelihood of changes compared to lung cases.
• Reviewer expertise and disease site were associated with the extent of changes made during contour review.

Conclusions:

• The quality of SBRT contour review is influenced by both the reviewer's disease-site expertise and the specific anatomical site.
• In departments with general coverage models, peer review outcomes can vary due to a lack of disease-site expert reviewers.