Radiotherapy and Oncology最新文献

{"title":"Association of the combined stereotactic radiosurgery and embolization strategy and long-term outcomes in brain arteriovenous malformations with a volume >10 ml: A nationwide multicenter observational prospective cohort study","authors":"Zhipeng Li ,&nbsp;Jun Zhang ,&nbsp;Heze Han ,&nbsp;Dezhi Gao ,&nbsp;Hengwei Jin ,&nbsp;Li Ma ,&nbsp;Ruinan Li ,&nbsp;Anqi Li ,&nbsp;Haibin Zhang ,&nbsp;Kexin Yuan ,&nbsp;Ke Wang ,&nbsp;Qinghui Zhu ,&nbsp;Chengzhuo Wang ,&nbsp;Debin Yan ,&nbsp;Junlin Lu ,&nbsp;Yukun Zhang ,&nbsp;Yang Zhao ,&nbsp;Youxiang Li ,&nbsp;Shibin Sun ,&nbsp;Yuanli Zhao ,&nbsp;Xiaolin Chen","doi":"10.1016/j.radonc.2024.110530","DOIUrl":"10.1016/j.radonc.2024.110530","url":null,"abstract":"<div><h3>Background</h3><p>To assess the long-term outcome of large brain arteriovenous malformations (AVMs) (volume &gt; 10 ml) underwent combined embolization and stereotactic radiosurgery (E+SRS) versus SRS alone.</p></div><div><h3>Methods</h3><p>Patients were recruited from a nationwide multicenter prospective collaboration registry (MATCH study, August 2011–August 2021) and categorized into E+SRS and SRS alone cohorts. Propensity score-matched survival analysis was employed to control for potential confounding variables. The primary outcome was a composite event of non-fatal hemorrhagic stroke or death. Secondary outcomes were favorable patient outcomes, AVM obliteration, favorable neurological outcomes, seizure, worsened mRS score, radiation-induced changes (RIC), and embolization complications. Furthermore, the efficacy of distinct embolization strategies was evaluated. Hazard ratios (HRs) were computed utilizing Cox proportional hazard models.</p></div><div><h3>Results</h3><p>Among 1063 AVMs who underwent SRS with or without prior embolization, 176 patients met the enrollment criteria. Following propensity score matching, the final analysis encompassed 98 patients (49 pairs). Median (interquartile range) follow-up duration for primary outcomes spanned 5.4 (2.7–8.4) years. Overall, the E+SRS strategy demonstrated a trend toward reduced incidence of primary outcomes compared to the SRS alone strategy (1.44 vs 2.37 per 100 patient-years; HR, 0.58 [95 % CI, 0.17–1.93]). Regardless of embolization degree or strategy, stratified analyses further consistently revealed a similar trend, albeit without achieving statistical significance. Secondary outcomes generally exhibited equivalence, but the combined approach showed potential superiority in most measures.</p></div><div><h3>Conclusions</h3><p>This study suggests a trend toward lower long-term non-fatal hemorrhagic stroke or death risks with the E+SRS strategy when compared to SRS alone in large AVMs (volume &gt; 10 ml).</p></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142164169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A patient-specific auto-planning method for MRI-guided adaptive radiotherapy in prostate cancer","authors":"Xiaonan Liu ,&nbsp;Xinyuan Chen ,&nbsp;Deqi Chen ,&nbsp;Yuxiang Liu ,&nbsp;Hong Quan ,&nbsp;Linrui Gao ,&nbsp;Lingling Yan ,&nbsp;Jianrong Dai ,&nbsp;Kuo Men","doi":"10.1016/j.radonc.2024.110525","DOIUrl":"10.1016/j.radonc.2024.110525","url":null,"abstract":"<div><h3>Background and purpose</h3><p>Fast and automated generation of treatment plans is desirable for magnetic resonance imaging (MRI)-guided adaptive radiotherapy (MRIgART). This study proposed a novel patient-specific auto-planning method and validated its feasibility in improving the existing online planning workflow.</p></div><div><h3>Materials and methods</h3><p>Data from 40 patients with prostate cancer were collected retrospectively. A patient-specific auto-planning method was proposed to generate adaptive treatment plans. First, a population dose-prediction model (<em>M₀</em>) was trained using data from previous patients. Second, a patient-specific model (<em>M_ps</em>) was created for each new patient by fine-tuning <em>M₀</em> with the patient’s data. Finally, an auto plan was optimized using the parameters derived from the predicted dose distribution by <em>M_ps</em>. The auto plans were compared with manual plans in terms of plan quality, efficiency, dosimetric verification, and clinical evaluation.</p></div><div><h3>Results</h3><p>The auto plans improved target coverage, reduced irradiation to the rectum, and provided comparable protection to other organs-at-risk. Target coverage for the planning target volume (+0.61 %, <em>P</em> = 0.023) and clinical target volume 4000 (+1.60 %, <em>P</em> &lt; 0.001) increased. V_2900cGy (−1.06 %, <em>P</em> = 0.004) and V_1810cGy (−2.49 %, <em>P</em> &lt; 0.001) to the rectal wall and V_1810cGy (−2.82 %, <em>P</em> = 0.012) to the rectum were significantly reduced. The auto plans required less planning time (−3.92 min, <em>P</em> = 0.001), monitor units (−46.48, <em>P</em> = 0.003), and delivery time (−0.26 min, <em>P</em> = 0.004), and their gamma pass rates (3 %/2 mm) were higher (+0.47 %, <em>P</em> = 0.014).</p></div><div><h3>Conclusion</h3><p>The proposed patient-specific auto-planning method demonstrated a robust level of automation and was able to generate high-quality treatment plans in less time for MRIgART in prostate cancer.</p></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical implementation of deep learning robust IMPT planning in oropharyngeal cancer patients: A blinded clinical study","authors":"Ilse G. van Bruggen ,&nbsp;Marije van Dijk ,&nbsp;Minke J. Brinkman-Akker ,&nbsp;Fredrik Löfman ,&nbsp;Johannes A. Langendijk ,&nbsp;Stefan Both ,&nbsp;E.W. Korevaar","doi":"10.1016/j.radonc.2024.110522","DOIUrl":"10.1016/j.radonc.2024.110522","url":null,"abstract":"<div><h3>Background and purpose</h3><p>This study aimed to evaluate the plan quality of our deep learning-based automated treatment planning method for robustly optimized intensity-modulated proton therapy (IMPT) plans in patients with oropharyngeal carcinoma (OPC). The assessment was conducted through a retrospective and prospective study, blindly comparing manual plans with deep learning plans.</p></div><div><h3>Materials and methods</h3><p>A set of 95 OPC patients was split into training (n = 60), configuration (n = 10), test retrospective study (n = 10), and test prospective study (n = 15). Our deep learning optimization (DLO) method combines IMPT dose prediction using a deep learning model with a robust mimicking optimization algorithm. Dosimetrists manually adjusted the DLO plan for individual patients. In both studies, manual plans and manually adjusted deep learning (mDLO) plans were blindly assessed by a radiation oncologist, a dosimetrist, and a physicist, through visual inspection, clinical goal evaluation, and comparison of normal tissue complication probability values. mDLO plans were completed within an average time of 2.5 h. In comparison, the manual planning process typically took around 2 days.</p></div><div><h3>Results</h3><p>In the retrospective study, in 10/10 (100%) patients, the mDLO plans were preferred, while in the prospective study, 9 out of 15 (60%) mDLO plans were preferred. In 4 out of the remaining 6 cases, the manual and mDLO plans were considered comparable in quality. Differences between manual and mDLO plans were limited.</p></div><div><h3>Conclusion</h3><p>This study showed a high preference for mDLO plans over manual IMPT plans, with 92% of cases considering mDLO plans comparable or superior in quality for OPC patients.</p></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S016781402403500X/pdfft?md5=756f01872c837c89ad1fdbd1c8e8830f&pid=1-s2.0-S016781402403500X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concerns regarding the use of only phase 2 study to Justify palliative radiotherapy vs. Palliative chemo-radiotherapy in unresectable head and neck cancer","authors":"Jay Dave","doi":"10.1016/j.radonc.2024.110526","DOIUrl":"10.1016/j.radonc.2024.110526","url":null,"abstract":"","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recording and reporting of ultra-high dose rate “FLASH” delivery for preclinical and clinical settings","authors":"Till Tobias Böhlen ,&nbsp;Serena Psoroulas ,&nbsp;Jack D Aylward ,&nbsp;Sam Beddar ,&nbsp;Alexandros Douralis ,&nbsp;Grégory Delpon ,&nbsp;Cristina Garibaldi ,&nbsp;Alessia Gasparini ,&nbsp;Emil Schüler ,&nbsp;Frank Stephan ,&nbsp;Raphaël Moeckli ,&nbsp;Anna Subiel","doi":"10.1016/j.radonc.2024.110507","DOIUrl":"10.1016/j.radonc.2024.110507","url":null,"abstract":"<div><p>Treatments at ultra-high dose rate (UHDR) have the potential to improve the therapeutic index of radiation therapy (RT) by sparing normal tissues compared to conventional dose rate irradiations. Insufficient and inconsistent reporting in physics and dosimetry of preclinical and translational studies may have contributed to a reproducibility crisis of radiobiological data in the field. Consequently, the development of a common terminology, as well as common recording, reporting, dosimetry, and metrology standards is required. In the context of UHDR irradiations, the temporal dose delivery parameters are of importance, and under-reporting of these parameters is also a concern.This work proposes a standardization of terminology, recording, and reporting to enhance comparability of both preclinical and clinical UHDR studies and and to allow retrospective analyses to aid the understanding of the conditions which give rise to the FLASH effect.</p></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of re-recurrent rectal cancer after curative treatment of locally recurrent rectal cancer","authors":"F. Piqeur ,&nbsp;L. Coolen ,&nbsp;S. Nordkamp ,&nbsp;D.M.J. Creemers ,&nbsp;R.H.N. Tijssen ,&nbsp;A.G.J. Neggers-Habraken ,&nbsp;H.J.T. Rutten ,&nbsp;J. Nederend ,&nbsp;C.A.M. Marijnen ,&nbsp;J.W.A. Burger ,&nbsp;H.M.U. Peulen","doi":"10.1016/j.radonc.2024.110520","DOIUrl":"10.1016/j.radonc.2024.110520","url":null,"abstract":"<div><h3>Purpose</h3><p>Substantiating data guiding clinical decision making in locally recurrent rectal cancer (LRRC) is lacking, specifically in target volume (TV) definition for chemoradiotherapy (CRT). A case-by-case review of local re-recurrences (re-LRRC) after multimodal treatment for LRRC was performed, to determine location of re-LRRC and assess whether treatment could have been improved.</p></div><div><h3>Methods</h3><p>All patients treated with curative intent for LRRC at the Catharina Hospital Eindhoven from October 2016 onwards, in whom complete imaging of (re-)LRRC and radiotherapy was available, were retrieved. Patients were discussed in plenary meetings with expert colorectal surgeons, radiation oncologists and radiologists. Each case was classified based on re-LRRC location, whether it was in accordance with the (current) radiotherapy protocol, and whether multimodal management would have been different in retrospect.</p></div><div><h3>Results</h3><p>Thirty-three cases were discussed. LRRC treatment was deemed suboptimal in 17/33 patients, due to different target volumes (13/17) and/or different surgery (9/17). 15/33 (46 %) of re-LRRC developed in-field of the prior radiotherapy TV, possibly showing RT-resistant disease. Other re-LRRCs developed out-field (n = 5, 15 %), marginally (n = 6, 18 %), or in a combined fashion (n = 7, 21 %). In retrospect, 48 % of cases were irradiated in line with current TV recommendations. TVs of 13/33 cases would have been altered if irradiated today.</p></div><div><h3>Conclusion</h3><p>This study highlights room for improvement within current standard-ofcare treatment for LRRC. Different surgical management or TVs may have improved outcome in up to half of discussed cases. Further delineation guideline development, incorporating the results from this study, may improve oncological outcome, specifically local control, for LRRC patients.</p></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adapting outside the box: Simulation-free MR-guided stereotactic ablative radiotherapy for prostate cancer","authors":"Jeremiah de Leon ,&nbsp;Urszula Jelen ,&nbsp;Madeline Carr ,&nbsp;David Crawford ,&nbsp;Maddison Picton ,&nbsp;Charles Tran ,&nbsp;Laura McKenzie ,&nbsp;Valery Peng ,&nbsp;Tania Twentyman ,&nbsp;Michael G. Jameson ,&nbsp;Vikneswary Batumalai","doi":"10.1016/j.radonc.2024.110527","DOIUrl":"10.1016/j.radonc.2024.110527","url":null,"abstract":"<div><h3>Background and purpose</h3><p>Magnetic resonance (MR)-guided radiotherapy (MRgRT) enhances treatment precision and adaptive capabilities, potentially supporting a simulation-free (sim-free) workflow. This work reports the first clinical implementation of a sim-free workflow using the MR-Linac for prostate cancer patients treated with stereotactic ablative radiotherapy (SABR).</p></div><div><h3>Materials and methods</h3><p>Fifteen patients who had undergone a prostate-specific membrane antigen positron emission tomography/CT (PSMA-PET/CT) scan as part of diagnostic workup were included in this work. Two reference plans were generated per patient: one using PSMA-PET/CT (sim-free plan) and the other using standard simulation CT (simCT plan). Dosimetric evaluations included comparisons between simCT, sim-free, and first fraction plans. Timing measurements were conducted to assess durations for both simCT and sim-free pre-treatment workflows.</p></div><div><h3>Results</h3><p>All 15 patients underwent successful treatment using a sim-free workflow. Dosimetric differences between simCT, sim-free, and first fraction plans were minor and within acceptable clinical limits, with no major violations of standardised criteria. The sim-free workflow took on average 130 min, while the simCT workflow took 103 min.</p></div><div><h3>Conclusion</h3><p>This work demonstrates the feasibility and benefits of sim-free MR-guided adaptive radiotherapy for prostate SABR, representing the first reported clinical experience in an ablative setting. By eliminating traditional simulation scans, this approach reduces patient burden by minimising hospital visits and enhances treatment accessibility.</p></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0167814024035059/pdfft?md5=aec6cfd6f46613eaf3f01ef7120b1d00&pid=1-s2.0-S0167814024035059-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidisciplinary team quality improves the survival outcomes of locally advanced rectal cancer patients: A post hoc analysis of the STELLAR trial","authors":"Huiying Ma ,&nbsp;Haoyue Li ,&nbsp;Tongzhen Xu ,&nbsp;Yuanhong Gao ,&nbsp;Shixin Liu ,&nbsp;Wenling Wang ,&nbsp;Lichun Wei ,&nbsp;Xishan Wang ,&nbsp;Liming Jiang ,&nbsp;Yihebali Chi ,&nbsp;Jinming Shi ,&nbsp;Jiacheng Shuai ,&nbsp;Shuangmei Zou ,&nbsp;Yong Cai ,&nbsp;Yuan Zhu ,&nbsp;Guanghui Cheng ,&nbsp;Hongyan Zhang ,&nbsp;Xin Wang ,&nbsp;Suyu Zhu ,&nbsp;Jun Wang ,&nbsp;Jing Jin","doi":"10.1016/j.radonc.2024.110524","DOIUrl":"10.1016/j.radonc.2024.110524","url":null,"abstract":"<div><h3>Purpose</h3><p>We sought to determine the association between multidisciplinary team (MDT) quality and survival of patients with locally advanced rectal cancer.</p></div><div><h3>Methods</h3><p>In a post hoc analysis of the randomized phase III STELLAR trial, 464 patients with distal or middle-third, clinical tumor category cT3-4 and/or regional lymph node-positive rectal cancer who completed surgery were evaluated. Disease-free survival (DFS) and Overall survival (OS) were stratified by Multidisciplinary team (MDT) quality, which was also included in the univariable and multivariable analyses of DFS and OS.</p></div><div><h3>Results</h3><p>According to the univariable analyses, a significantly worse DFS was associated with a fewer specialized medical disciplines participating in MDT (&lt;5 vs ≥ 5; <em>P</em>=0.049),a lower frequency of MDT meetings (&lt;once a week vs ≥ once a week; <em>P</em>=0.021) and a smaller MDT annual discussion volume of rectal cancer (≤200 vs &gt; 200; <em>P</em>=0.039). In addition, a lower number of specialized medical disciplines participating in MDT (&lt;5 vs ≥ 5; <em>P</em>&lt;0.001), a lower frequency of MDT meetings (&lt;once a week vs ≥ once a week; <em>P</em>&lt;0.001) and a smaller MDT annual discussion volume of rectal cancer (≤200 vs &gt; 200; <em>P</em>=0.001) were the variables associated with OS. These 3 factors were considered when assessing MDT quality, which was classified into 2 categories: high quality or general quality. Patients treated in hospitals with high MDT quality had longer 3-year OS (90.5 % vs 78.1 %; <em>P</em>=0.001) and similar 3-year DFS (70.3 % vs 61.3 %; <em>P</em>=0.109) compared to those treated in hospitals of the general MDT quality group. Furthermore, multivariable analys<strong>e</strong>s revealed a significance for DFS (HR, 1.648; 95 % CI, 1.143–2.375; <em>P</em>=0.007) and OS (HR, 2.771; 95 % CI, 1.575–4.877; <em>P</em>&lt;0.001) in MDT quality.</p></div><div><h3>Conclusions</h3><p>The use of hospitals with optimized multidisciplinary infrastructure had a significant influence on survival of patients with locally advanced rectal cancer.</p></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0167814024035023/pdfft?md5=3bbecd73ece600c6eaef87da35c7960c&pid=1-s2.0-S0167814024035023-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Semi-automated reproducible target transfer for cardiac radioablation – A multi-center cross-validation study within the RAVENTA trial","authors":"Stephan Hohmann ,&nbsp;Jingyang Xie ,&nbsp;Miriam Eckl ,&nbsp;Melanie Grehn ,&nbsp;Nizar Karfoul ,&nbsp;Christian Janorschke ,&nbsp;Roland Merten ,&nbsp;Boris Rudic ,&nbsp;Daniel Buergy ,&nbsp;Evgeny Lyan ,&nbsp;David Krug ,&nbsp;Felix Mehrhof ,&nbsp;Leif-Hendrik Boldt ,&nbsp;Stefanie Corradini ,&nbsp;Hannah Fanslau ,&nbsp;Lena Kaestner ,&nbsp;Adrian Zaman ,&nbsp;Frank A. Giordano ,&nbsp;David Duncker ,&nbsp;Jürgen Dunst ,&nbsp;Judit Boda-Heggemann","doi":"10.1016/j.radonc.2024.110499","DOIUrl":"10.1016/j.radonc.2024.110499","url":null,"abstract":"<div><h3>Background</h3><p>Stereotactic arrhythmia radioablation (STAR) is a therapeutic option for ventricular tachycardia (VT) where catheter-based ablation is not feasible or has previously failed. Target definition and its transfer from electro-anatomic maps (EAM) to radiotherapy treatment planning systems (TPS) is challenging and operator-dependent. Software solutions have been developed to register EAM with cardiac CT and semi-automatically transfer 2D target surface data into 3D CT volume coordinates. Results of a cross-validation study of two conceptually different software solutions using data from the RAVENTA trial (NCT03867747) are reported.</p></div><div><h3>Methods</h3><p>Clinical Target Volumes (CTVs) were created from target regions delineated on EAM using two conceptually different approaches by separate investigators on data of 10 patients, blinded to each other’s results. Targets were transferred using 3D-3D registration and 2D-3D registration, respectively. The resulting CTVs were compared in a core-lab using two complementary analysis software packages for structure similarity and geometric characteristics.</p></div><div><h3>Results</h3><p>Volumes and surface areas of the CTVs created by both methods were comparable: 14.88 ± 11.72 ml versus 15.15 ± 11.35 ml and 44.29 ± 33.63 cm² versus 46.43 ± 35.13 cm². The <span>Dice-</span>coefficient was 0.84 ± 0.04; median surface-distance and <span>Hausdorff</span>-distance were 0.53 ± 0.37 mm and 6.91 ± 2.26 mm, respectively. The 3D-center-of-mass difference was 3.62 ± 0.99 mm. Geometrical volume similarity was 0.94 ± 0.05 %.</p></div><div><h3>Conclusion</h3><p>The STAR targets transferred from EAM to TPS using both software solutions resulted in nearly identical 3D structures. Both solutions can be used for QA (quality assurance) and EAM-to-TPS transfer of STAR-targets. Semi-automated methods could potentially help to avoid mistargeting in STAR and offer standardized workflows for methodically harmonized treatments.</p></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0167814024007692/pdfft?md5=7caf28a8639411db03430f07ae26df2e&pid=1-s2.0-S0167814024007692-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep learning-assisted interactive contouring of lung cancer: Impact on contouring time and consistency","authors":"Michael J. Trimpl ,&nbsp;Sorcha Campbell ,&nbsp;Niki Panakis ,&nbsp;Daniel Ajzensztejn ,&nbsp;Emma Burke ,&nbsp;Shawn Ellis ,&nbsp;Philippa Johnstone ,&nbsp;Emma Doyle ,&nbsp;Rebecca Towers ,&nbsp;Geoffrey Higgins ,&nbsp;Claire Bernard ,&nbsp;Roland Hustinx ,&nbsp;Katherine A. Vallis ,&nbsp;Eleanor P.J. Stride ,&nbsp;Mark J. Gooding","doi":"10.1016/j.radonc.2024.110500","DOIUrl":"10.1016/j.radonc.2024.110500","url":null,"abstract":"<div><h3>Background and Purpose</h3><p>To evaluate the impact of a deep learning (DL)-assisted interactive contouring tool on inter-observer variability and the time taken to complete tumour contouring.</p></div><div><h3>Materials and Methods</h3><p>Nine clinicians contoured the gross tumour volume (GTV) using the PET-CT scans of 10 non-small cell lung cancer (NSCLC) patients, either using DL-assisted or manual contouring tools. After contouring a case using one contouring method, the same case was contoured one week later using the other method. The contours and time taken were compared.</p></div><div><h3>Results</h3><p>Use of the DL-assisted tool led to a statistically significant decrease in active contouring time of 23 % relative to the standard manual segmentation method (p &lt; 0.01). The mean observation time for all clinicians and cases made up nearly 60 % of interaction time for both contouring approaches. On average the time spent contouring per case was reduced from 22 min to 19 min when using the DL-assisted tool. Additionally, the DL-assisted tool reduced contour variability in the parts of tumour where clinicians tended to disagree the most, while the consensus contour was similar whichever of the two contouring approaches was used.</p></div><div><h3>Conclusions</h3><p>A DL-assisted interactive contouring approach decreased active contouring time and local inter-observer variability when used to delineate lung cancer GTVs compared to a standard manual method. Integration of this tool into the clinical workflow could assist clinicians in contouring tasks and improve contouring efficiency.</p></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0167814024007709/pdfft?md5=8fc6323e4fa571961ec2a84da65d7a36&pid=1-s2.0-S0167814024007709-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}