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Japanese Journal of Clinical Oncology Advance Access originally published online on March 12, 2008
Japanese Journal of Clinical Oncology 2008 38(4):275-280; doi:10.1093/jjco/hyn014
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© The Author (2008). Published by Oxford University Press. All rights reserved

Variation of Clinical Target Volume Definition among Japanese Radiation Oncologists in External Beam Radiotherapy for Prostate Cancer

Katsumasa Nakamura1, Yoshiyuki Shioyama2, Sunao Tokumaru3, Nobuyuki Hayashi4, Natsuo Oya5, Yoshiyuki Hiraki6, Kazuo Kusuhara7, Takafumi Toita8, Hiroaki Suefuji9, Naofumi Hayabuchi9, Hiromi Terashima10, Masaoki Makino11 and Kenichi Jingu12

1 Department of Radiology, School of Medicine, Fukuoka University, Fukuoka
2 Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka
3 Department of Radiology, Faculty of Medicine, Saga University, Saga
4 Department of Radiology, Nagasaki University School of Medicine, Nagasaki
5 Department of Radiation Oncology, Kumamoto University Hospital, Kumamoto
6 Department of Radiology, Kagoshima University School of Medicine, Kagoshima
7 Department of Radiology, Miyazaki Medical College, Miyazaki
8 Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Okinawa
9 Department of Radiology, Kurume University School of Medicine, Kurume, Fukuoka
10 Department of Health Sciences, School of Medicine, Kyushu University, Fukuoka
11 Department of Radiology, National Hospital Organization Kagoshima Medical Center, Kagoshima
12 Division of Radiation Oncology, St. Mary's Hospital, Fukuoka, Japan

For reprints and all correspondence: Katsumasa Nakamura, Department of Radiology, School of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180 Japan. E-mail: nakam{at}fukuoka-u.ac.jp

Received November 29, 2007; accepted February 7, 2008

Background: We investigated the interobserver variation in the prostate target volume and the trend toward the use of diagnostic computed tomography (CT) or magnetic resonance (MR) images for treatment planning.

Methods: Twenty-five radiation oncologists were asked to draw the external contour of the prostate on CT images (0.3 cm spacing) of a patient with localized prostate cancer. They also answered a questionnaire regarding the use of diagnostic CT or MR images for the contouring.

Results: Of the 25 physicians, 28% rarely or never referred to the diagnostic CT images. In contrast, the physicians tended to refer to the MR images more frequently. Approximately 50% of the physicians believed in the usefulness of contrast-enhanced images for the delineation of the prostate. As for the variation of the prostate contouring, the median craniocaudal prostate length was 36 mm (range, 21–54 mm), and the median prostate volume was 43.5 cm3 (range, 23.8–98.3 cm3). The interobserver variability was not significant in the duration as a radiation oncologist, the board certification status as radiation oncologists, and the number of treatment plans developed for prostate cancer during the last 1 year.

Conclusion: A wide variety of the definitions of the prostate was found among Japanese radiation oncologists.

Key Words: radiation oncology • urologic-RadOncol • radiology-CT/MRI


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