All CT and MRI images were transferred to ITK-SNAP software (version 3.4.0, www.itksnap.org) for analysis. GTV of ICC was independently delineated on CT and MRI images by one radiation oncologist (with 4 years of clinical experience in liver tumor radiotherapy) and three radiologists (with 3, 5 and 8 years of experience in liver imaging, respectively). GTV delineation included the visible tumor area as shown in Figure 1. For multiple hepatic lesions, only the largest one was chosen for GTV delineation. None of the four observers knew any clinical information of patients. Tumor volume was automatically calculated after GTV delineation. The average tumor volume delineated by the four observers was set as the final tumor volume. Delineation of GTV by the four observers via consensus was considered as the benchmark (18). Dice similarity coefficient (DSC) is the measurement for the spatial overlap between two delineations A and B (19). DSC was calculated using the following equation with an in-house program based on Matlab software (MathWorks Inc., Natick, MA, USA):

GTV delineation for ICC. (A) The location of ICC; (B) the delineation of GTV slice by slice; (C,D) exhibited the GTV delineation on sagittal and coronal views, respectively.

where A was the volume of GTV for an observer and B was the volume of GTV for the benchmark. DSC ≥0.8 indicated almost perfect agreement (20).

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