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Lin D, Wahid KA, Nelms BE, He R, Naser MA, Duke S, Sherer MV, Christodouleas JP, Mohamed ASR, Cislo M, Murphy JD, Fuller CD, Gillespie EF. E pluribus unum: prospective acceptability benchmarking from the Contouring Collaborative for Consensus in Radiation Oncology crowdsourced initiative for multiobserver segmentation. J Med Imaging (Bellingham) 2023; 10:S11903. [PMID: 36761036 PMCID: PMC9907021 DOI: 10.1117/1.jmi.10.s1.s11903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 01/02/2023] [Indexed: 02/11/2023] Open
Abstract
Purpose Contouring Collaborative for Consensus in Radiation Oncology (C3RO) is a crowdsourced challenge engaging radiation oncologists across various expertise levels in segmentation. An obstacle to artificial intelligence (AI) development is the paucity of multiexpert datasets; consequently, we sought to characterize whether aggregate segmentations generated from multiple nonexperts could meet or exceed recognized expert agreement. Approach Participants who contoured ≥ 1 region of interest (ROI) for the breast, sarcoma, head and neck (H&N), gynecologic (GYN), or gastrointestinal (GI) cases were identified as a nonexpert or recognized expert. Cohort-specific ROIs were combined into single simultaneous truth and performance level estimation (STAPLE) consensus segmentations.STAPLE nonexpert ROIs were evaluated againstSTAPLE expert contours using Dice similarity coefficient (DSC). The expert interobserver DSC (IODSC expert ) was calculated as an acceptability threshold betweenSTAPLE nonexpert andSTAPLE expert . To determine the number of nonexperts required to match theIODSC expert for each ROI, a single consensus contour was generated using variable numbers of nonexperts and then compared to theIODSC expert . Results For all cases, the DSC values forSTAPLE nonexpert versusSTAPLE expert were higher than comparator expertIODSC expert for most ROIs. The minimum number of nonexpert segmentations needed for a consensus ROI to achieveIODSC expert acceptability criteria ranged between 2 and 4 for breast, 3 and 5 for sarcoma, 3 and 5 for H&N, 3 and 5 for GYN, and 3 for GI. Conclusions Multiple nonexpert-generated consensus ROIs met or exceeded expert-derived acceptability thresholds. Five nonexperts could potentially generate consensus segmentations for most ROIs with performance approximating experts, suggesting nonexpert segmentations as feasible cost-effective AI inputs.
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Affiliation(s)
- Diana Lin
- Memorial Sloan Kettering Cancer Center, Department of Radiation Oncology, New York, New York, United States
| | - Kareem A. Wahid
- The University of Texas MD Anderson Cancer Center, Department of Radiation Oncology, Houston, Texas, United States
| | | | - Renjie He
- The University of Texas MD Anderson Cancer Center, Department of Radiation Oncology, Houston, Texas, United States
| | - Mohammed A. Naser
- The University of Texas MD Anderson Cancer Center, Department of Radiation Oncology, Houston, Texas, United States
| | - Simon Duke
- Cambridge University Hospitals, Department of Radiation Oncology, Cambridge, United Kingdom
| | - Michael V. Sherer
- University of California San Diego, Department of Radiation Medicine and Applied Sciences, La Jolla, California, United States
| | - John P. Christodouleas
- The University of Pennsylvania Cancer Center, Department of Radiation Oncology, Philadelphia, Pennsylvania, United States
- Elekta AB, Stockholm, Sweden
| | - Abdallah S. R. Mohamed
- The University of Texas MD Anderson Cancer Center, Department of Radiation Oncology, Houston, Texas, United States
| | - Michael Cislo
- Memorial Sloan Kettering Cancer Center, Department of Radiation Oncology, New York, New York, United States
| | - James D. Murphy
- University of California San Diego, Department of Radiation Medicine and Applied Sciences, La Jolla, California, United States
| | - Clifton D. Fuller
- The University of Texas MD Anderson Cancer Center, Department of Radiation Oncology, Houston, Texas, United States
| | - Erin F. Gillespie
- Memorial Sloan Kettering Cancer Center, Department of Radiation Oncology, New York, New York, United States
- University of Washington Fred Hutchinson Cancer Center, Department of Radiation Oncology, Seattle, Washington, United States
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