title: Interobserver variability of clinical target volume delineation in supra-diaphragmatic Hodgkin's disease: a multi-institutional experience.
abstract: BACKGROUND
  To determine interobserver variability in clinical target volume (CTV) of supra-diaphragmatic Hodgkin's lymphoma.
  
  
  METHODS
  At the 2008 AIRO (Italian Society of Radiation Oncology) Meeting, the Radiation Oncology Department of Chieti proposed a multi-institutional contouring dummy-run of two cases of early stage supra-diaphragmatic Hodgkin's lymphoma after chemotherapy. Clinical history, diagnostics, and planning CT imaging were available on Chieti's radiotherapy website (www.radioterapia.unich.it). Participating centers were requested to delineate the CTV and submit it to the coordinating center. To quantify interobserver variability of CTV delineations, the total volume, craniocaudal, laterolateral, and anteroposterior diameters were calculated.
  
  
  RESULTS
  A total of 18 institutions for case A and 15 institutions for case B submitted the targets. Case A presented significant variability in total volume (range: 74.1-1,157.1 cc), craniocaudal (range: 6.5-22.5 cm; median: 16.25 cm), anteroposterior (range: 5.04-14.82 cm; median: 10.28 cm), and laterolateral diameters (range: 8.23-22.88 cm; median: 15.5 cm). Mean CTV was 464.8 cc (standard deviation: 280.5 cc). Case B presented significant variability in total volume (range: 341.8-1,662 cc), cranio-caudal (range: 8.0-28.5 cm; median: 23 cm), anteroposterior (range: 7.9-1.8 cm; median: 11.1 cm), and laterolateral diameters (range: 12.9-24.0 cm; median: 18.8 cm). Mean CTV was 926.0 cc (standard deviation: 445.7 cc).
  
  
  CONCLUSIONS
  This significant variability confirms the need to apply specific guidelines to improve contouring uniformity in Hodgkin's lymphoma.
authors: Department of Radiation Oncology, "G. d'Annunzio" University of Chieti, SS. Annunziata Hospital, Chieti, Italy. d.genovesi@tin.it
authors: Domenico
authors: D
authors: Genovesi
authors: Giampiero Ausili
authors: GA
authors: Cèfaro
authors: Annamaria
authors: A
authors: Vinciguerra
authors: Antonietta
authors: A
authors: Augurio
authors: Monica
authors: M
authors: Di Tommaso
authors: Rita
authors: R
authors: Marchese
authors: Umberto
authors: U
authors: Ricardi
authors: Andrea Riccardo
authors: AR
authors: Filippi
authors: Theodore
authors: T
authors: Girinsky
authors: Katiuscia
authors: K
authors: Di Biagio
authors: Maurizio
authors: M
authors: Belfiglio
authors: Enza
authors: E
authors: Barbieri
authors: Vincenzo
authors: V
authors: Valentini
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