Delineation guidelines for organs at risk involved in radiation-induced salivary dysfunction and xerostomia

Water, Tara A. van de; Bijl, H.P.; Westerlaan, Henriëtte E.; Langendijk, Johannes A.

doi:10.1016/j.radonc.2009.09.008

Cited by 102 publications

(79 citation statements)

References 42 publications

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“…22,23 The intra-and interobserver variability is well known in literature. 8,14,15,18,22,23 Similar results were obtained in the publication by Song et al 15 Song et al compared the delineation process for the prostate on KVCT and MVCT. The uncertainty in prostate contouring (prostate has the HU value near the "soft tissue" and "muscles" in this study) was higher on MVCT vs. KVCT.…”

Section: Discussionsupporting

confidence: 74%

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Influence of the type of imaging on the delineation process during the treatment planning

Jackowiak

Bąk

Kowalik

et al. 2015

Reports of Practical Oncology & Radiotherapy

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a b s t r a c tAim: The aim of this study was to compare the intra-and interobserver contouring variability for structures with density of organ at risk in two types of tomography: kilovoltage computed tomography (KVCT) versus megavoltage computed tomography (MVCT). The intraand interobserver differences were examined on both types of tomography for structures which simulate human tissue or organs. Materials and methods:Six structures with density of the liver, bone, trachea, lung, soft tissue and muscle were created and used. For the measurements, the special water phantom with all structures was designed. To evaluate interobserver variability, five observers delineated the structures in both types of computed tomography (CT).Results: Intraobserver variability was in the range of 1-14% and was the largest for the liver. (51.86 vs. 67.97), the volume on MVCT was smaller than KVCT. The statistically significant differences between observers were observed for structures with density of the liver, bone and soft tissue on KVCT and for the liver, lung and soft tissue on MVCT. For the structures with density of the trachea and muscles, there were no significant differences for both types of tomography.Conclusions: During the contouring process the interobserver and intraobserver contouring uncertainty was larger on MVCT, especially for structures with HU near 80, compared with KVCT.

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Section: Discussionsupporting

confidence: 74%

“…All observers were instructed to delineate the structures on their own set of scans under the condition that the break between two contouring sessions should be at least 1 week. 14,15 Observers did not have the access to the scans of other participants of the study. The support tools were HU scale and zooming.…”

Section: Methodsmentioning

confidence: 99%

Influence of the type of imaging on the delineation process during the treatment planning

Jackowiak

Bąk

Kowalik

et al. 2015

Reports of Practical Oncology & Radiotherapy

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“…The isotropic PTV concept was used for IMRT and IMPT planning for better comparability of dose distributions outside target volumes and same intersection of OARs with PTV. Published guidelines were applied for parotid gland25 and brachial plexus delineation26, 27 and internal guidelines for spinal cord, brain stem, and mandible delineation. Artifacts in soft tissue arising from metal implants were contoured and overwritten before dose calculation.…”

Section: Methodsmentioning

confidence: 99%

Potential proton and photon dose degradation in advanced head and neck cancer patients by intratherapy changes

Stützer

Jakobi

Bandurska-Luque

et al. 2017

J Applied Clin Med Phys

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PurposeEvaluation of dose degradation by anatomic changes for head‐and‐neck cancer (HNC) intensity‐modulated proton therapy (IMPT) relative to intensity‐modulated photon therapy (IMRT) and identification of potential indicators for IMPT treatment plan adaptation.MethodsFor 31 advanced HNC datasets, IMPT and IMRT plans were recalculated on a computed tomography scan (CT) taken after about 4 weeks of therapy. Dose parameter changes were determined for the organs at risk (OARs) spinal cord, brain stem, parotid glands, brachial plexus, and mandible, for the clinical target volume (CTV) and the healthy tissue outside planning target volume (PTV). Correlation of dose degradation with target volume changes and quality of rigid CT matching was investigated.ResultsRecalculated IMPT dose distributions showed stronger degradation than the IMRT doses. OAR analysis revealed significant changes in parotid median dose (IMPT) and near maximum dose (D 1ml) of spinal cord (IMPT, IMRT) and mandible (IMPT). OAR dose parameters remained lower in IMPT cases. CTV coverage (V 95%) and overdose (V 107%) deteriorated for IMPT plans to (93.4 ± 5.4)% and (10.6 ± 12.5)%, while those for IMRT plans remained acceptable. Recalculated plans showed similarly decreased PTV conformity, but considerable hotspots, also outside the PTV, emerged in IMPT cases. Lower CT matching quality was significantly correlated with loss of PTV conformity (IMPT, IMRT), CTV homogeneity and coverage (IMPT). Target shrinkage correlated with increased dose in brachial plexus (IMRT, IMPT), hotspot generation outside the PTV (IMPT) and lower PTV conformity (IMRT).ConclusionsThe study underlines the necessity of precise positioning and monitoring of anatomy changes, especially in IMPT which might require adaptation more often. Since OAR doses remained typically below constraints, IMPT plan adaptation will be indicated by target dose degradations.

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“…Each CTV was automatically expanded in order to generate the corresponding planning target volume (PTV) with an isotropic 3 mm margin, while assuring that the edge of the distribution was at least 2 mm from the skin. The contour of parotid glands referred to the standard of van de Water et al [15].…”

Section: Delineation and The Dose To Target Volumes And Organs At Rismentioning

confidence: 99%

Replanning Criteria and Timing Definition for Parotid Protection-Based Adaptive Radiation Therapy in Nasopharyngeal Carcinoma

Yao

et al. 2014

International Journal of Radiation Oncology*Biology*Physics

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Delineation guidelines for organs at risk involved in radiation-induced salivary dysfunction and xerostomia

Cited by 102 publications

References 42 publications

Influence of the type of imaging on the delineation process during the treatment planning

Influence of the type of imaging on the delineation process during the treatment planning

Potential proton and photon dose degradation in advanced head and neck cancer patients by intratherapy changes

Replanning Criteria and Timing Definition for Parotid Protection-Based Adaptive Radiation Therapy in Nasopharyngeal Carcinoma

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