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Related Experiment Videos

Radiotherapy portal verification: an observer study

R Bissett1, S Boyko, K Leszczynski

  • 1Department of Radiation Oncology, Northeastern Ontario Regional Cancer Centre, Sudbury, Canada.

The British Journal of Radiology
|February 1, 1995
PubMed
Summary
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Radiotherapy portal verification is subjective and unreliable. This study confirms significant inconsistencies in geometric accuracy assessments, highlighting the need for objective methods in portal imaging.

Area of Science:

  • Medical Physics
  • Radiation Oncology
  • Radiotherapy Quality Assurance

Background:

  • Current radiotherapy portal verification relies on subjective visual comparison of images.
  • The reliability of this subjective assessment process is largely unknown.
  • On-line portal imaging systems are increasingly used for real-time verification.

Purpose of the Study:

  • To quantitatively assess the reliability of subjective radiotherapy portal verification.
  • To evaluate interobserver agreement in geometric accuracy assessments.
  • To compare on-line versus off-line assessment reliability.

Main Methods:

  • 16 observers (oncologists, physicists, therapists) evaluated 530 treatment fields from 45 patients.
  • Images were acquired using the BEAMVIEW on-line portal imaging system.

Related Experiment Videos

  • The kappa statistic was used to measure interobserver and on-line/off-line agreement.

    • Main Results:

    • Significant variation was observed in observers' geometric accuracy assessments.
    • The best interobserver agreement (between oncologists) was rated only as "fair".
    • Agreement between on-line and off-line therapist assessments was rated as "poor".

    Conclusions:

    • Subjective evaluation of radiotherapy field accuracy is statistically confirmed as unreliable.
    • The degree of unreliability in current portal verification is surprisingly large.
    • Eliminating subjective decision-making is crucial for reliable radiotherapy portal verification.