{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T03:57:23Z","timestamp":1792727843719,"version":"4.5.0"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T00:00:00Z","timestamp":1721001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T00:00:00Z","timestamp":1721001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Radiat Oncol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The planification of radiation therapy (RT) for pancreatic cancer (PC) requires a dosimetric computed tomography (CT) scan to define the gross tumor volume (GTV). The main objective of this study was to compare the inter-observer variability in RT planning between the arterial and the venous phases following intravenous contrast.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PANCRINJ was a prospective monocentric study that included twenty patients with non-metastatic PC. Patients underwent a pre-therapeutic CT scan at the arterial and venous phases. The delineation of the GTV was performed by one radiologist (gold standard) and two senior radiation oncologists (operators). The primary objective was to compare the Jaccard conformity index (JCI) for the GTVs computed between the GS (gold standard) and the operators between the arterial and the venous phases with a Wilcoxon signed rank test for paired samples. The secondary endpoints were the geographical miss index (GMI), the kappa index, the intra-operator variability, and the dose-volume histograms between the arterial and venous phases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The median JCI for the arterial and venous phases were 0.50 (range, 0.17\u20130.64) and 0.41 (range, 0.23\u20130.61) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.10) respectively. The median GS-GTV was statistically significantly smaller compared to the operators at the arterial (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001) and venous phases (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), respectively. The GMI were low with few tumors missed for all patients with a median GMI of 0.07 (range, 0-0.79) and 0.05 (range, 0-0.39) at the arterial and venous phases, respectively (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.15). There was a moderate agreement between the radiation oncologists with a median kappa index of 0.52 (range 0.38\u20130.57) on the arterial phase, and 0.52 (range 0.36\u20130.57) on the venous phase (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.08). The intra-observer variability for GTV delineation was lower at the venous phase than at the arterial phase for the two operators. There was no significant difference between the arterial and the venous phases regarding the dose-volume histogram for the operators.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our results showed inter- and intra-observer variability in delineating GTV for PC without significant differences between the arterial and the venous phases. The use of both phases should be encouraged. Our findings suggest the need to provide training for radiation oncologists in pancreatic imaging and to collaborate within a multidisciplinary team.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13014-024-02477-8","type":"journal-article","created":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T12:02:47Z","timestamp":1721044967000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A comparison of target volumes drawn on arterial and venous phase scans during radiation therapy planning for patients with pancreatic cancer: the PANCRINJ study"],"prefix":"10.1186","volume":"19","author":[{"given":"Fabien","family":"Zaidi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Calame","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9dric","family":"Chevalier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Henriques","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dewi","family":"Vernerey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucine","family":"Vuitton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Heyd","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Borg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jihane","family":"Boustani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,7,15]]},"reference":[{"key":"2477_CR1","unstructured":"13-Pancreas fact sheet. In: Global Cancer Observatory 2020. https:\/\/gco.iarc.fr\/today\/data\/factsheets\/cancers\/13-Pancreas-fact-sheet.pdf. Accessed 11 Aug 2022."},{"key":"2477_CR2","unstructured":"SPF. Estimations nationales de l\u2019incidence et de la mortalit\u00e9 par cancer en France m\u00e9tropolitaine entre 1990 et 2018 - Tumeurs solides: \u00c9tude \u00e0 partir des registres des cancers du r\u00e9seau Francim. In Sante Publique France. https:\/\/www.santepubliquefrance.fr\/import\/estimations-nationales-de-l-incidence-et-de-la-mortalite-par-cancer-en-france-metropolitaine-entre-1990-et-2018-tumeurs-solides-etude-a-partir. Accessed 11 Aug 2022."},{"issue":"11","key":"2477_CR3","doi-asserted-by":"publisher","first-page":"1039","DOI":"10.1056\/NEJMra1404198","volume":"371","author":"DP Ryan","year":"2014","unstructured":"Ryan DP, Hong TS, Bardeesy N. Pancreatic adenocarcinoma. N Engl J Med. 2014;371(11):1039\u201349.","journal-title":"N Engl J Med"},{"key":"2477_CR4","unstructured":"Pancreatic Adenocarcinoma version 2.2023. In NCCN, National Comprehensive Cancer Network. https:\/\/www.nccn.org\/guidelines\/guidelines-detail. Accessed 27 Aug 2023."},{"issue":"17","key":"2477_CR5","doi-asserted-by":"publisher","first-page":"1844","DOI":"10.1001\/jama.2016.4324","volume":"315","author":"P Hammel","year":"2016","unstructured":"Hammel P, Huguet F, van Laethem JL, Goldstein D, Glimelius B, Artru P, et al. Effect of Chemoradiotherapy vs Chemotherapy on Survival in patients with locally Advanced Pancreatic Cancer Controlled after 4 months of Gemcitabine with or without Erlotinib: the LAP07 Randomized Clinical Trial. JAMA. 2016;315(17):1844\u201353.","journal-title":"JAMA"},{"key":"2477_CR6","doi-asserted-by":"crossref","unstructured":"Neuzillet C, Gaujoux S, Williet N, Bachet JB, Bauguion L, Colson Durand L et al. Pancreatic cancer: French clinical practice guidelines for diagnosis, treatment and follow-up (SNFGE, FFCD, GERCOR, UNICANCER, SFCD, SFED, SFRO, ACHBT, AFC). Dig liver dis off J ital soc gastroenterol Ital Assoc Study Liver. 2018;50(12):1257\u201371.","DOI":"10.1016\/j.dld.2018.08.008"},{"issue":"1\u20132","key":"2477_CR7","first-page":"259","volume":"26","author":"F Huguet","year":"2022","unstructured":"Huguet F, Del Rivin E, Orthuon A, Mornex F, Bessi\u00e8res I, Guimas V, et al. Radiation therapy of pancreatic cancers. Cancer Radiother J Soc Francaise Radiother Oncol. 2022;26(1\u20132):259\u201365.","journal-title":"Cancer Radiother J Soc Francaise Radiother Oncol"},{"issue":"3","key":"2477_CR8","doi-asserted-by":"publisher","first-page":"432","DOI":"10.1016\/j.radonc.2015.08.026","volume":"117","author":"E Fokas","year":"2015","unstructured":"Fokas E, Clifford C, Spezi E, Joseph G, Branagan J, Hurt C, et al. Comparison of investigator-delineated gross tumor volumes and quality assurance in pancreatic cancer: analysis of the pretrial benchmark case for the SCALOP trial. Radiother Oncol J Eur Soc Ther Radiol Oncol. 2015;117(3):432\u20137.","journal-title":"Radiother Oncol J Eur Soc Ther Radiol Oncol"},{"issue":"2","key":"2477_CR9","doi-asserted-by":"publisher","first-page":"212","DOI":"10.1016\/j.radonc.2016.07.002","volume":"120","author":"E Fokas","year":"2016","unstructured":"Fokas E, Spezi E, Patel N, Hurt C, Nixon L, Chu KY, et al. Comparison of investigator-delineated gross tumour volumes and quality assurance in pancreatic cancer: analysis of the on-trial cases for the SCALOP trial. Radiother Oncol. 2016;120(2):212\u20136.","journal-title":"Radiother Oncol"},{"issue":"3","key":"2477_CR10","doi-asserted-by":"publisher","first-page":"801","DOI":"10.1016\/j.ijrobp.2006.12.053","volume":"68","author":"JD Murphy","year":"2007","unstructured":"Murphy JD, Adusumilli S, Griffith KA, Ray ME, Zalupski MM, Lawrence TS, et al. Full-dose gemcitabine and concurrent radiotherapy for unresectable pancreatic cancer. Int J Radiat Oncol Biol Phys. 2007;68(3):801\u20138.","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"3","key":"2477_CR11","doi-asserted-by":"publisher","first-page":"697","DOI":"10.1148\/radiology.199.3.8637990","volume":"199","author":"DS Lu","year":"1996","unstructured":"Lu DS, Vedantham S, Krasny RM, Kadell B, Berger WL, Reber HA. Two-phase helical CT for pancreatic tumors: pancreatic versus hepatic phase enhancement of tumor, pancreas, and vascular structures. Radiology. 1996;199(3):697\u2013701.","journal-title":"Radiology"},{"issue":"1","key":"2477_CR12","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1148\/radiol.2411051338","volume":"241","author":"S Goshima","year":"2006","unstructured":"Goshima S, Kanematsu M, Kondo H, Yokoyama R, Miyoshi T, Kato H, et al. Pancreas: optimal scan delay for contrast-enhanced multi-detector row CT. Radiology. 2006;241(1):167\u201374.","journal-title":"Radiology"},{"issue":"8","key":"2477_CR13","doi-asserted-by":"publisher","first-page":"1028","DOI":"10.6004\/jnccn.2017.0131","volume":"15","author":"MA Tempero","year":"2017","unstructured":"Tempero MA, Malafa MP, Al-Hawary M, Asbun H, Bain A, Behrman SW, et al. Pancreatic adenocarcinoma, Version 2.2017, NCCN Clinical Practice guidelines in Oncology. J Natl Compr Cancer Netw JNCCN. 2017;15(8):1028\u201361.","journal-title":"J Natl Compr Cancer Netw JNCCN"},{"key":"2477_CR14","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1016\/j.radonc.2020.07.052","volume":"154","author":"TB Brunner","year":"2021","unstructured":"Brunner TB, Haustermans K, Huguet F, Morganti AG, Mukherjee S, Belka C, et al. ESTRO ACROP guidelines for target volume definition in pancreatic cancer. Radiother Oncol J Eur Soc Ther Radiol Oncol. 2021;154:60\u20139.","journal-title":"Radiother Oncol J Eur Soc Ther Radiol Oncol"},{"issue":"3","key":"2477_CR15","doi-asserted-by":"publisher","first-page":"525","DOI":"10.1016\/j.radonc.2010.08.007","volume":"97","author":"GM Cattaneo","year":"2010","unstructured":"Cattaneo GM, Passoni P, Sangalli G, Slim N, Longobardi B, Mancosu P, et al. Internal target volume defined by contrast-enhanced 4D-CT scan in unresectable pancreatic tumour: evaluation and reproducibility. Radiother Oncol. 2010;97(3):525\u20139.","journal-title":"Radiother Oncol"},{"issue":"1","key":"2477_CR16","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1186\/s13014-017-0777-0","volume":"12","author":"E Versteijne","year":"2017","unstructured":"Versteijne E, Gurney-Champion OJ, van der Horst A, Lens E, Kolff MW, Buijsen J, et al. Considerable interobserver variation in delineation of pancreatic cancer on 3DCT and 4DCT: a multi-institutional study. Radiat Oncol Lond Engl. 2017;12(1):58.","journal-title":"Radiat Oncol Lond Engl"},{"issue":"7","key":"2477_CR17","doi-asserted-by":"publisher","first-page":"923","DOI":"10.1080\/0284186X.2017.1304654","volume":"56","author":"OJ Gurney-Champion","year":"2017","unstructured":"Gurney-Champion OJ, Versteijne E, van der Horst A, Lens E, R\u00fctten H, Heerkens HD, et al. Addition of MRI for CT-based pancreatic tumor delineation: a feasibility study. Acta Oncol Stockh Swed. 2017;56(7):923\u201330.","journal-title":"Acta Oncol Stockh Swed"},{"issue":"3","key":"2477_CR18","doi-asserted-by":"publisher","first-page":"745","DOI":"10.1007\/s13246-019-00774-1","volume":"42","author":"H Lee","year":"2019","unstructured":"Lee H, Yoon J, Park K, Rim CH, Chung MJ, Seong J. Dose perturbation by metallic biliary stent in external beam radiotherapy of pancreato-biliary cancers. Australas Phys Eng Sci Med. 2019;42(3):745\u201356.","journal-title":"Australas Phys Eng Sci Med"},{"key":"2477_CR19","first-page":"112","volume":"100","author":"D Nash","year":"2022","unstructured":"Nash D, Juneja S, Palmer AL, van Herk M, McWilliam A, Osorio EV. The geometric and dosimetric effect of algorithm choice on propagated contours from CT to cone beam CTs. Phys Med PM Int J Devoted Appl Phys Med Biol off J Ital Assoc Biomed Phys AIFB. 2022;100:112\u20139.","journal-title":"Phys Med PM Int J Devoted Appl Phys Med Biol off J Ital Assoc Biomed Phys AIFB"},{"key":"2477_CR20","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1186\/s13014-015-0372-1","volume":"10","author":"IS Ramadaan","year":"2015","unstructured":"Ramadaan IS, Peick K, Hamilton DA, Evans J, Iupati D, Nicholson A, et al. Validation of Varian\u2019s SmartAdapt\u00ae deformable image registration algorithm for clinical application. Radiat Oncol Lond Engl. 2015;10:73.","journal-title":"Radiat Oncol Lond Engl"},{"issue":"5","key":"2477_CR21","doi-asserted-by":"publisher","first-page":"589","DOI":"10.1080\/0284186X.2021.1891282","volume":"60","author":"RL Christiansen","year":"2021","unstructured":"Christiansen RL, Johansen J, Zukauskaite R, Hansen CR, Bertelsen AS, Hansen O, et al. Accuracy of automatic structure propagation for daily magnetic resonance image-guided head and neck radiotherapy. Acta Oncol Stockh Swed. 2021;60(5):589\u201397.","journal-title":"Acta Oncol Stockh Swed"},{"issue":"11","key":"2477_CR22","doi-asserted-by":"publisher","first-page":"973","DOI":"10.1007\/s00066-023-02085-7","volume":"199","author":"E Gkika","year":"2023","unstructured":"Gkika E, Kostyszyn D, Fechter T, Moustakis C, Ernst F, Boda-Heggemann J, et al. Interobserver agreement on definition of the target volume in stereotactic radiotherapy for pancreatic adenocarcinoma using different imaging modalities. Strahlenther Onkol Organ Dtsch Rontgengesellschaft Al. 2023;199(11):973\u201381.","journal-title":"Strahlenther Onkol Organ Dtsch Rontgengesellschaft Al"},{"issue":"2","key":"2477_CR23","doi-asserted-by":"publisher","first-page":"475","DOI":"10.1016\/S0360-3016(01)02822-X","volume":"53","author":"MJ Murphy","year":"2002","unstructured":"Murphy MJ, Martin D, Whyte R, Hai J, Ozhasoglu C, Le QT. The effectiveness of breath-holding to stabilize lung and pancreas tumors during radiosurgery. Int J Radiat Oncol Biol Phys. 2002;53(2):475\u201382.","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"3","key":"2477_CR24","doi-asserted-by":"publisher","first-page":"884","DOI":"10.1016\/j.ijrobp.2009.02.003","volume":"74","author":"M Feng","year":"2009","unstructured":"Feng M, Balter JM, Normolle D, Adusumilli S, Cao Y, Chenevert TL, et al. Characterization of pancreatic tumor motion using cine MRI: surrogates for tumor position should be used with caution. Int J Radiat Oncol Biol Phys. 2009;74(3):884\u201391.","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"3","key":"2477_CR25","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1016\/j.radonc.2008.04.007","volume":"87","author":"P Mancosu","year":"2008","unstructured":"Mancosu P, Bettinardi V, Passoni P, Gusmini S, Cappio S, Gilardi MC, et al. Contrast enhanced 4D-CT imaging for target volume definition in pancreatic ductal adenocarcinoma. Radiother Oncol J Eur Soc Ther Radiol Oncol. 2008;87(3):339\u201342.","journal-title":"Radiother Oncol J Eur Soc Ther Radiol Oncol"},{"issue":"10","key":"2477_CR26","doi-asserted-by":"publisher","first-page":"5659","DOI":"10.1118\/1.4963213","volume":"43","author":"W Choi","year":"2016","unstructured":"Choi W, Xue M, Lane BF, Kang MK, Patel K, Regine WF, et al. Individually optimized contrast-enhanced 4D-CT for radiotherapy simulation in pancreatic ductal adenocarcinoma. Med Phys. 2016;43(10):5659.","journal-title":"Med Phys"},{"issue":"9","key":"2477_CR27","doi-asserted-by":"publisher","first-page":"1257","DOI":"10.3109\/0284186X.2014.905699","volume":"53","author":"E Lens","year":"2014","unstructured":"Lens E, van der Horst A, Kroon PS, van Hooft JE, D\u00e1vila Fajardo R, Fockens P, et al. Differences in respiratory-induced pancreatic tumor motion between 4D treatment planning CT and daily cone beam CT, measured using intratumoral fiducials. Acta Oncol Stockh Swed. 2014;53(9):1257\u201364.","journal-title":"Acta Oncol Stockh Swed"}],"container-title":["Radiation Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13014-024-02477-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13014-024-02477-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13014-024-02477-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T12:05:55Z","timestamp":1721045155000},"score":1,"resource":{"primary":{"URL":"https:\/\/ro-journal.biomedcentral.com\/articles\/10.1186\/s13014-024-02477-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,15]]},"references-count":27,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["2477"],"URL":"https:\/\/doi.org\/10.1186\/s13014-024-02477-8","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-3840055\/v1","asserted-by":"object"}]},"ISSN":["1748-717X"],"issn-type":[{"value":"1748-717X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,15]]},"assertion":[{"value":"6 January 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 June 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 July 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was approved by our research department, trial registration: 2021\/640; 08\/10\/2021.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"90"}}