Annotations for Combination Chemotherapy and Surgery in Treating Young Patients With Wilms Tumor

This dataset contains image annotations derived from the NCI Clinical Trial "<a href="https://cancerimagingarchive.net/collection/aren0534/" target="_blank" rel="noopener">Combination Chemotherapy and Surgery in Treating Young Patients With Wilms Tumor (AREN0534)</a>”.  This dataset was generated as part of an NCI project to augment TCIA datasets with annotations that will improve their value for cancer researchers and AI developers.<h3><strong>Annotation Protocol</strong></h3>For each patient, all scans were reviewed to identify and annotate the clinically relevant time points and sequences/series. Scans were initially annotated by an international team of radiologists holding MBBS degrees or higher, which were then reviewed by US-based board-certified radiologists to ensure accuracy. In a typical patient the following time points were annotated:<ol><li>Pre-surgical CT chest and CT/MRI abdomen</li><li>CT chest and/or CT/MRI abdomen at 6 weeks</li><li>Possible CT/MRI abdomen at 12 weeks.</li><li>Any negative imaging included past 12 weeks was annotated as negative. If any included imaging past 12 weeks is positive for tumor, the last positive exam was annotated.</li></ol>In a typical patient the following annotation rules were followed:<ol><li>The primary renal tumor(s) were annotated on post-contrast axial series. Normal renal parenchyma were excluded.</li><li>A maximum of 5 lesions were annotated per patient scan (timepoint); no more than 2 per organ. The same 5 lesions were annotated at each time point.  RECIST 1.1 principles were followed for lesion annotation, however, if <5 lesions measuring >1 cm were present, then smaller lesions were annotated, again up to 2 lesions per organ or 5 lesions per patient scan. Bone lesions were included if other lesions were not present.</li><li>Lesions were labeled separately.</li><li>Seed points were automatically generated but reviewed by a radiologist.</li><li>To ensure a high standard of accuracy and data quality, each annotation was reviewed by a secondary reader.</li></ol>At each time point:<ol><li>A seed point (kernel) was created for each segmented structure. The seed points for each segmentation are provided in a separate DICOM RTSS file.</li><li>SNOMED-CT “Anatomic Region Sequence” and “Segmented Property Category Code Sequence” and codes were inserted for all segmented structures.</li><li>Imaging time point codes were inserted to help identify each annotation in the context of the clinical trial assessment protocol.<ol><li>“Clinical Trial Time Point ID” was used to encode time point type using one of the following strings as applicable: “pre-dose”, “post-chemotherapy”, or “post-operative”.</li><li>Content Item in “Acquisition Context Sequence” will be added containing "Time Point Type" using Concept Code Sequence (0040,A168) selected from:<ol><li>(255235001, SCT, “Pre-dose”)</li><li>(262502001, SCT, "Post-chemotherapy")</li><li>(262061000, SCT, "Post-operative")</li></ol></li></ol></li></ol><h3>Important supplementary information and sample code</h3><ol><li>A spreadsheet containing key details about the annotations is available in the <strong>Data Access</strong> section below.</li><li>A Jupyter notebook demonstrating how to use the <a href="https://wiki.cancerimagingarchive.net/display/NBIA/NBIA+Data+Retriever+Command-Line+Interface+Guide">NBIA Data Retriever Command-Line Interface</a> application and the <a href="https://wiki.cancerimagingarchive.net/display/Public/NBIA+Search+with+Authentication+REST+API+Guide">REST API (with authentication)</a> to access these data can be found in the <strong>Additional Resources</strong> section below.</li></ol>

本数据集收录了源自美国国家癌症研究所（NCI）临床试验项目《年轻威尔姆斯肿瘤患者联合化疗与手术治疗的临床研究》（AREN0534）的图像标注信息。该数据集的生成旨在作为NCI项目的一部分，通过添加标注来增强TCIA数据集的价值，以满足癌症研究者和AI开发者的需求。

## 标注协议

针对每位患者，对所有扫描图像进行了审查，以识别并标注临床相关的时间点及序列/系列。初始标注由持有MBBS学位或更高学位的国际放射学专家团队完成，随后由美国执业认证的放射学专家进行复核，以确保标注的准确性。在典型患者中，标注了以下时间点：

<ol>
<li>术前胸部CT和腹部CT/MRI</li>
<li>6周时的胸部CT和/或腹部CT/MRI</li>
<li>12周可能的腹部CT/MRI。</li>
<li>12周之后包含的任何阴性影像均被标注为阴性。若12周之后包含的影像为肿瘤阳性，则标注最后一次阳性检查。</li>
</ol>

在典型患者中，遵循以下标注规则：

<ol>
<li>在对比增强后的轴位序列上标注主要肾脏肿瘤（肿瘤）。正常肾脏实质被排除在外。</li>
<li>每位患者的扫描图像（时间点）最多标注5个病灶，每个器官不超过2个；每个时间点标注的5个病灶相同。遵循RECIST 1.1原则进行病灶标注，然而，若存在5个以上大于1厘米的病灶，则标注较小的病灶，每个器官或每位患者扫描图像最多标注2个病灶。若其他病灶不存在，则包括骨病灶。</li>
<li>病灶分别进行标注。</li>
<li>种子点自动生成，但需由放射学专家进行复核。</li>
<li>为确保标注的准确性和数据质量达到高标准，每位标注均经过另一位读者的复核。</li>
</ol>

在每个时间点：

<ol>
<li>为每个分割结构创建一个种子点（核）。</li>
<li>每个分割的种子点提供在单独的DICOM RTSS文件中。</li>
<li>插入SNOMED-CT“解剖区域序列”和“分割属性类别代码序列”及代码，以涵盖所有分割结构。</li>
<li>插入影像时间点代码，以帮助在临床试验评估协议的背景下识别每个标注。</li>
<li>使用“临床试验时间点ID”对时间点类型进行编码，适用于以下字符串之一：“术前剂量”、“化疗后”或“术后”。</li>
<li>在“采集上下文序列”中添加内容项，包含“时间点类型”，使用概念代码序列（0040,A168）选择，如下所示：</li>
<li>(255235001, SCT, “术前剂量”)</li>
<li>(262502001, SCT, “化疗后”)</li>
<li>(262061000, SCT, “术后”）</li>
</ol>

## 重要的补充信息和示例代码

<ol>
<li>包含标注关键细节的电子表格可在下方的“数据访问”部分找到。</li>
<li>展示如何使用<a href="https://wiki.cancerimagingarchive.net/display/NBIA/NBIA+Data+Retriever+Command-Line+Interface+Guide">NBIA数据检索命令行界面</a>应用程序和<a href="https://wiki.cancerimagingarchive.net/display/Public/NBIA+Search+with+Authentication+REST+API+Guide">REST API（带认证）</a>访问这些数据的Jupyter笔记本可在下方的“额外资源”部分找到。</li>
</ol>