Predicting the impact of target volume contouring variations on the organ at risk dose: results of a qualitative survey
Bibliographic record
Abstract
Purpose Integrating auto-contouring in radiotherapy workflows is shifting the role of radiation oncologists from manual delineation to reviewing and correcting automatically generated contours. However, we postulate that this process is hindered by significant inter-evaluator variability in assessing the dosimetric impact of contour variations. This study investigates how radiation oncologists and medical physicists evaluate the impact of glioblastoma target volume (TV) variations on the dose to organs at risk (OARs), focusing on understanding inter-evaluator variability and decision-making patterns. Methods A qualitative survey was conducted involving four radiation oncologists and three medical physicists. Participants classified 54 glioblastoma TV contour variations using up to four changes each across 14 patients as “better,” “no change,” or “worse” regarding their expected impact on the dose to OARs. The corresponding ground truth labels were derived from standardized treatment plans. Inter-evaluator variability was analyzed using Cohen’s Kappa. Results Substantial variability was observed, with Cohen’s Kappa values ranging from weak to moderate agreement (0.33–0.74). Evaluators frequently overestimated the negative impact of contour variations, misclassifying 46% of “no change” variations as “Worse.” No evaluator judged contour variations as resulting in “better” doses to OARs, despite this being the case for 4 variations. Conclusion Significant variability in estimating the dosimetric impact of contour variations underscores the critical need for standardized guidelines to reduce inconsistencies and allow for the assessment of automatically generated contours based on clinically meaningful factors. Evaluators frequently overestimated the negative impact of contour variations, potentially leading to inefficiencies and unnecessary contour corrections in clinical practice.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.041 | 0.102 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".