This dataset contains image annotations derived from the NCI Clinical Trial "Combination Chemotherapy With or Without Radiation Therapy in Treating Young Patients With Newly Diagnosed Stage III or Stage IV Wilms Tumor (AREN0533)”.  The key objective of this project is to generate a large and highly curated imaging dataset of pediatric Wilms tumor patients with annotations suitable for cancer researchers and AI developers.

Annotation Protocol

For each patient, every DICOM Study and DICOM Series was reviewed to identify and annotate the clinically relevant time points and sequences. In a typical patient the following time points will be annotated:

1. Pre-treatment CT chest and abdomen
2. CT chest and/or CT abdomen at 6 weeks
3. Possible CT abdomen at 12 weeks. 

In a typical patient the following annotation rules were followed:

1. The primary renal tumor(s) were annotated on post contrast axial series. Normal renal parenchyma were excluded. 
2. 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. 
3. RECIST 1.1 principles were generally 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.
4. Bone lesions were included if other lesions were not present. 

At each timepoint volumetric segmentations, seed points and negative finding assessments (DICOM RTSTRUCT) were created.  SNOMED-CT “Anatomic Region Sequence” and “Segmented Property Category Code Sequence” and codes were inserted for all segmented structures.  Imaging time point codes were inserted to help identify each annotation in the context of the clinical trial assessment protocol.   “Clinical Trial Time Point ID” was used to encode time point type using one of the following strings as applicable: “pre-dose” or “post-chemotherapy”.  The Content Item in “Acquisition Context Sequence” was added containing "Time Point Type" using Concept Code Sequence (0040,A168) selected from:

• (255235001, SCT, “Pre-dose”)
• (262502001, SCT, "Post-chemotherapy")
• (262502001, SCT, "Post-chemotherapy")

Important supplementary information and sample code

1. A spreadsheet containing a variety of useful metadata about the annotations is available in the Data Access section below.
2. Important information about how to interpret the DICOM annotation data can be found on the Detailed Description section below.  It includes information about specific tags which document where the tumor was found, whether it was enhancing/non-enhancing, which study time point the annotation relates to, details for lesion tracking across time points, etc.
3. A Jupyter notebook demonstrating how to use the NBIA Data Retriever Command-Line Interface application and our REST API (with authentication) to access these data can be found in the Additional Resources section below.