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This dataset contains image annotations derived from the NCI Clinical Trial "Combination Chemotherapy and Radiation Therapy in Treating Young Patients With Newly Diagnosed Hodgkin Lymphoma (AHOD0831)”.  The key objective of this project is to generate a large and highly curated imaging dataset of pediatric Hodgkin lymphoma 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/series. In a typical patient all available time points were annotated:

In a typical patient the following annotation rules were followed:

1. PERCIST criteria was followed. Specifically, the lesions estimated to have the most elevated SUVmax were annotated. 
2. Lesions were annotated in the axial plane. If no axial plane was available, lesions were annotated in the coronal plane. 
3. Lesions were annotated on the attenuation corrected PET series as well as the diagnostic contrast enhanced CT. If no diagnostic contrast enhanced CT is available for that timepoint, then the non contrast CT portion of the PET/CT was annotated. 
4. A maximum of 5 lesions were annotated per patient scan (timepoint); no more than 2 per organ. For the purposes of this project, the lymph nodes constitute 1 organ, while other lymphatic structures such as the spleen, salivary glands, and Waldeyer’s ring structures constitute separate organs.  The same 5 lesions were annotated at each time point.  RECIST 1.1 principles will be followed. Specifically, lymph nodes were annotated if > 1.5 cm in short axis. Other lesions were annotated if > 1 cm.  
5. Lesions were labeled separately.
6. Seed points were automatically generated but reviewed by a radiologist.
7. To ensure a high standard of accuracy and data quality, each annotation was reviewed by a secondary reader.

At each time point:

1. A seed point (kernel) was will be created for each segmented structure. The seed points for each segmentation are provided in a separate DICOM RTSS file. 
2. SNOMED-CT “Anatomic Region Sequence” and “Segmented Property Category Code Sequence” and codes were will be inserted for all segmented structures.
3. “Tracking ID” and “Tracking UID” tags were will be inserted for each segmented structure to enable longitudinal lesion tracking.
4. Imaging time point codes were will be inserted to help identify each annotation in the context of the clinical trial assessment protocol. 
5. (255235001, SCT, “Pre-dose”)
6. (262502001, SCT, "Post-chemotherapy")
(262502001, SCT, "Post-chemotherapy")
7. (262502001, SCT, "Post-chemotherapy")
8. (262502001, SCT, "Post-chemotherapy")
9. (262502001, SCT, "Post-chemotherapy")
10. (262502001, SCT, "Post-chemotherapy")
1. “Clinical Trial Time Point ID” was will be used to encode time point type using one of the following strings as applicable: “pre-dose” or “post-chemotherapy”
2. Content Item in “Acquisition Context Sequence” was will be added containing "Time Point Type" using Concept Code Sequence (0040,A168) selected from:
1. (255235001, SCT, “Pre-dose”)
2. (262502001, SCT, "Post-chemotherapy")