Interobserver variability in radiation therapy plan output: Results of a single-institution study Journal Article


Authors: Berry, S. L.; Boczkowski, A.; Ma, R.; Mechalakos, J.; Hunt, M.
Article Title: Interobserver variability in radiation therapy plan output: Results of a single-institution study
Abstract: Purpose We investigated the sources of variability in radiation therapy treatment plan output between planners within a single institution. Methods and materials Forty treatment planners across 5 campuses of an institution created a plan on the same thoracic esophagus patient computed tomography scan and structure set. Plans were scored and ranked based on the planner's adherence to an ordered list of target dose coverage and normal tissue evaluation criteria. A runs test was used to identify whether any of the studied planner qualities influenced the ranking. Spearman rank correlation was used to investigate whether plan score correlated with years of experience or planned monitor units. Results The distribution of scores, ranging from 80.24 to 135.89, was negatively skewed (mean, 128.7; median, 131.5). No statistically significant relationship between plan score and campus (P = .193), job title (P = .174), previous outside experience (P = .611), or number of gantry angles (P = .156) was discovered. No statistical correlation between plan score and monitor unit or years of experience was found. Conclusions Despite clear and established critical organ dose criteria and well-documented planning guidelines, planning variation still occurs, even among members of the same institution. Because plan consistency does not seem to significantly correlate with experience, career path, or campus, investigation into alternate methods beyond additional education and training to reduce this variation, such as knowledge-based planning or advanced optimization techniques, is necessary. © 2016 American Society for Radiation Oncology
Journal Title: Practical Radiation Oncology
Volume: 6
Issue: 6
ISSN: 1879-8519
Publisher: Elsevier Inc.  
Date Published: 2016-11-01
Start Page: 442
End Page: 449
Language: English
DOI: 10.1016/j.prro.2016.04.005
PROVIDER: scopus
PMCID: PMC5099085
PUBMED: 27374191
DOI/URL:
Notes: Article -- Export Date: 6 December 2016 -- Source: Scopus
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  1. Sean L Berry
    69 Berry
  2. Margie A Hunt
    287 Hunt
  3. Rongtao   Ma
    9 Ma