After application of the atlas, reported mean doses to the whole heart, left main artery, left anterior descending interventricular branch, and right coronary artery were within 0.1, 0.9, 2.6, and 0.6 Gy, respectively, of gold standard doses. Percent overlap and concordance index of observer-contoured cardiac and gold standard volumes were 2.3-fold improved for all structures (p < 0.002). The cardiac atlas significantly improved contour accuracy and concordance. Pre- and post-atlas values were analyzed using a paired t test. Doses to observer-contoured cardiac structures were calculated and compared with gold standard contour doses. The concordance index was also calculated.
Contour accuracy was assessed by percent overlap with gold standard atlas volumes. Seven radiation oncologists were recruited to delineate the whole heart, left main and left anterior descending interventricular branches, and right coronary arteries on four cases before and after studying the atlas. Here we have developed a heart atlas and evaluated its effect on contour accuracy and concordance.Ī detailed cardiac computed tomography scan atlas was developed jointly by cardiology, cardiac radiology, and radiation oncology. However, the relationship between dose to cardiac structures and subsequent toxicity has not been well defined, partially due to variations in substructure delineation, which can lead to inconsistent dose reporting and the failure to detect potential correlations. Cardiac toxicity is an important sequela of breast radiotherapy.
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