Technical Innovations and Patient Support in Radiation Oncology最新文献

{"title":"A dedicated institutional clinical workflow and peer-review meeting for reirradiation","authors":"Pauline Dupuis ,&nbsp;Magali Sandt ,&nbsp;Guillaume Beldjoudi ,&nbsp;Coralie Moncharmont ,&nbsp;Anne-Agathe Serre ,&nbsp;Line Claude ,&nbsp;Marie-Pierre Sunyach ,&nbsp;Myriam Ayadi","doi":"10.1016/j.tipsro.2025.100366","DOIUrl":"10.1016/j.tipsro.2025.100366","url":null,"abstract":"<div><h3>Background and Purpose</h3><div>Reirradiation (reRT) is a clinical challenge and requires organisational and technical efforts to standardise and ensure safety of practices. An institutional clinical workflow developed to manage and support systematic approach for patients’ reRT was presented in this work.</div></div><div><h3>Materials and Methods</h3><div>The workflow included a standardised approach for reRT detection and identification in patient folder in the oncology information system, previous treatment data collection, pre-treatment planning analysis of overlaps and acceptable cumulative radiobiological equieffective doses (EQD2Gy) to organs at risk, a final validation of new treatment plan using image registration and EQD2Gy dose accumulation, and a multidisciplinary peer review meeting. Statistics were compiled on reRT activity at our institution between 2020 and 2023 and the reRT peer-review meeting and the workflow were assessed through a survey addressed to young radiation oncologists (RO).</div></div><div><h3>Results</h3><div>During the studied period, 1920 treatments were declared as reRT at our institution. The first reRT site was the brain, followed by spine, thorax and breast. The most commonly used techniques for reRT were stereotactic radiotherapy or volumetric modulated arc therapy. The youngRO survey showed that more than 80% of respondents found a benefit of peer-review meeting, with a particular interest in discussions on cumulative equieffective dose limits and cumulative doses validation. The majority of them declared they gained confidence in their reRT practice.</div></div><div><h3>Conclusions</h3><div>The implementation of a standardized institutional workflow for reRT management helped harmonize practices within our institution to support our reRT workload. Feedback from young RO highlighted the value of peer-review meetings which contributed to increase their confidence in reRT practices.</div></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"37 ","pages":"Article 100366"},"PeriodicalIF":2.8,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145738703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Setup and target volume shape variation in rectal cancer radiotherapy: a systematic literature review","authors":"Giovanna Mantello ,&nbsp;Elena Galofaro ,&nbsp;Cihan Gani ,&nbsp;Daniel Portik ,&nbsp;Lynsey Devlin ,&nbsp;Robin De Roover ,&nbsp;Ane Appelt ,&nbsp;Rianne de Jong","doi":"10.1016/j.tipsro.2025.100359","DOIUrl":"10.1016/j.tipsro.2025.100359","url":null,"abstract":"<div><h3>Introduction</h3><div>This systematic literature review aimed to evaluate treatment uncertainties associated with modern rectal cancer radiotherapy, focusing on systematic and random errors in setup and target volume (TV) shape variation, with the aim of supporting clinics in optimizing treatment accuracy and consistency in daily practice.</div></div><div><h3>Methods</h3><div>A systematic literature review was conducted to quantify geometrical uncertainties with respect to setup and TV shape variations in the treatment of rectal cancer. It included studies reporting uncertainties for setup, CTV (Clinical Target Volume) shape variations (rectum and mesorectum), GTVp (Gross Tumor Volume – Primary Tumor), GTVn (Gross Tumor Volume − Nodes), and/or elective pelvic lymph nodes; excluding non-English language publications.</div></div><div><h3>Results</h3><div>196 reports were assessed for full text screening and 32 publications were selected for final reporting. Most authors utilized on board imaging to calculate setup errors and TV shape variation, and all reported substantial uncertainties. Setup uncertainty was reported to be very different for prone (w/o belly board) vs supine position, in favour of supine position. TV shape variation showed large systematic and random errors, especially for GTVp and the upper anterior part of the mesorectum. A subset of publications analyzed the positional uncertainties of elective draining lymph nodes, which are typically not removed during surgery, showing their small positional variations in relation to bone structures.</div></div><div><h3>Conclusion</h3><div>Setup and TV shape variation are significant and non-negligible geometric uncertainties. Setup errors can largely be minimized with daily (2D or 3D) IGRT, whereas TV shape variations—particularly in the mesorectum—needs to be assessed daily with 3D imaging and requires anisotropic margins.</div></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"37 ","pages":"Article 100359"},"PeriodicalIF":2.8,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145791733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breast cancer patients with ipsilateral diaphragm paralysis: practical breast radiotherapy using continuous positive airway pressure-assisted breathing to spare normal organs","authors":"Whoon Jong Kil ,&nbsp;Wyatt Smith ,&nbsp;David Cousins","doi":"10.1016/j.tipsro.2025.100363","DOIUrl":"10.1016/j.tipsro.2025.100363","url":null,"abstract":"<div><h3>Purpose</h3><div>To describe organs at risk (OARs)-sparing breast cancer (BC) radiotherapy (RT) for patients with ipsilateral (Ipsi-diaphragm) paralysis using continuously positive airway pressure (CPAP) and supine tangential RT-field.</div></div><div><h3>Material and method</h3><div>Breast RT plans with free-breathing (FB) for a patient with right-sided BC (patient1) and another patient with left-sided BC (patient2) showed an elevated Ipsi-diaphragm and displaced portions of liver (patient1) and the heart and intestine (patient2) into supine tangential RT-field. Although both patients denied cardiopulmonary symptoms, their elevated diaphragm, liver, intestine and the heart were unchanged with deep-inspiration breath hold (DIBH) while contralateral diaphragm moved caudally suggesting clinical diagnosis of Ipsi-diaphragm paralysis. Subsequently, patients underwent CT-sim under CPAP to create supine tangential breast RT plan.</div></div><div><h3>Result</h3><div>Compared with FB, CPAP inflated lungs and moved both patients paralyzed diaphragm, liver, heart, and intestine caudally and displaced these OARs away from breast RT-field. The liver volume within right supine tangential RT-fields in patient1 was 163 cc with FB versus 12 cc with CPAP (93 % reduction). The heart and intestine were completely outside the left supine tangential RT-field with CPAP in patient2. For dosimetric comparison, supine tangential RT-fields for breast-only RT were used with prescription of 40 Gy in 15 fractions on each patients’ CT-sim with FB and CPAP, respectively. Compared with FB, CPAP reduced liver volume receiving ≥ 30 Gy by 94 % (FB:140 vs CPAP:8 cc) in patient1 and mean dose to the heart by 67 % (FB:2.7 vs CPAP:0.9 Gy) and left anterior descending artery by 84 % (FB:25 vs CPAP:3.9 Gy), maximum dose to the intestine by 90 % (FB:40.6 vs CPAP:4.4 Gy).</div></div><div><h3>Conclusion</h3><div>BC patients with Ipsi-diaphragm paralysis, CPAP provided an effective and practical technique for OARs-sparing breast RT.</div></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"37 ","pages":"Article 100363"},"PeriodicalIF":2.8,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145791732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of nursing intervention using an adverse event predictive model for head and neck carbon-ion radiotherapy: A prospective clinical study","authors":"Chika Hirai ,&nbsp;Atsushi Musha ,&nbsp;Hirofumi Shimada ,&nbsp;Yoko Kitada ,&nbsp;Tatsuya Ohno","doi":"10.1016/j.tipsro.2025.100364","DOIUrl":"10.1016/j.tipsro.2025.100364","url":null,"abstract":"<div><h3>Introduction</h3><div>Radiation dermatitis and oral mucositis are common acute toxicities from carbon-ion radiotherapy (CIRT) for head and neck cancers. These toxicities often impair quality of life (QOL) and can lead to treatment interruption. This study evaluated a dose surface model (DSM) shared by patients and nurses to determine whether it helped patients become more aware of their symptoms and improve their self-care.</div></div><div><h3>Methods</h3><div>This prospective study enrolled 46 patients with head and neck malignancies who underwent CIRT between July 2017 and December 2019. The study program included nurse interviews and administration of the DSM-based patient self-care instructions, which were conducted before treatment, every week during CIRT, and at 1 and 2 months post-treatment. The self-care checklist and daily care frequency data were assessed. QOL was evaluated using the Short Form 8 at baseline, end of CIRT, and 2 months post-CIRT.</div></div><div><h3>Results</h3><div>Radiation dermatitis occurred in 98% of the patients (grades 2–3 in 24%) and oral mucositis in 48% (grades 2–3). The self-care checklist scores improved significantly throughout the latter half of the treatment and post-treatment periods. Self-care frequency did not significantly correlate with adverse event severity, although mouth rinsing frequency tended to increase. Two months after treatment, QOL improved across several domains, particularly mental health.</div></div><div><h3>Conclusion</h3><div>The DSM-based nursing intervention program effectively enhanced patient awareness and confidence in managing radiation-induced skin and mucosal toxicities. This strategy may enhance supportive care and QOL during CIRT for head and neck cancers.</div></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"37 ","pages":"Article 100364"},"PeriodicalIF":2.8,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145738702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urgent radiotherapy for superior vena cava syndrome in metastatic non-small cell lung cancer: a case report","authors":"Arpeet Patel ,&nbsp;Nilanjan Haldar ,&nbsp;Ida Micaily ,&nbsp;Michael Greenberg ,&nbsp;Evan Nardone ,&nbsp;John A. Lippert ,&nbsp;Christopher Fundakowski ,&nbsp;Adam C. Mueller","doi":"10.1016/j.tipsro.2025.100365","DOIUrl":"10.1016/j.tipsro.2025.100365","url":null,"abstract":"<div><div>Superior vena cava (SVC) syndrome is a life-threatening complication of thoracic malignancies, requiring rapid management in the setting of airway compromise or hemodynamic instability. We present a 59-year-old male with metastatic non-small cell lung cancer (NSCLC) who developed superior vena cava syndrome (SVCS) due to compression from a large mediastinal mass identified as metastatic lung adenocarcinoma. His declining respiratory status progressed rapidly, necessitating intensive care. After extensive multidisciplinary collaboration, the patient was determined fit for inpatient radiation therapy and 10 fractions of 300 cGy external beam radiotherapy to the obstructing lesion was planned. However, the patient was unable to lay supine for radiation treatment due to dyspnea, so he was transferred to an academic center, where custom immobilization setup was available to accommodate the patient’s inability to tolerate a standardized supine position utilized by most outpatient radiation centers. The patient’s symptoms and oxygen requirement then improved markedly, enabling transition to outpatient care for the remaining two radiotherapy (RT) fractions and chemotherapy. This case highlights the value of hypofractionated radiotherapy and institutional adaptability in managing acute oncologic emergencies such as SVC syndrome.</div></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"37 ","pages":"Article 100365"},"PeriodicalIF":2.8,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145791730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Green radiotherapy: aitro survey on sustainability awareness among Italian radiation therapists","authors":"Claudio Votta ,&nbsp;Andrea Lastrucci ,&nbsp;Nicola Iosca ,&nbsp;Davide Bassani ,&nbsp;Lucrezia Bernabucci ,&nbsp;Mattia Bertolini ,&nbsp;Carmela Galdieri ,&nbsp;Danilo Pasini ,&nbsp;Valerio Pisoni ,&nbsp;Aurora Zucca ,&nbsp;Daniele Lambertini ,&nbsp;Patrizia Cornacchione","doi":"10.1016/j.tipsro.2025.100360","DOIUrl":"10.1016/j.tipsro.2025.100360","url":null,"abstract":"<div><h3>Introduction</h3><div>Sustainability has become a growing priority in healthcare, including radiotherapy. Promoting sustainable practices is crucial to reducing environmental impact, optimizing resource use, and improving departmental efficiency. This study, conducted by the Italian Association of Radiation Therapy and Medical Physics Technologists (AITRO), aimed to explore the culture of sustainability among Italian radiation therapists (RTTs).</div></div><div><h3>Methods</h3><div>A nationwide anonymous survey was developed by a focus group of RTTs from AITRO’s to ensure clinical relevance. The 17-question questionnaire, divided into five thematic areas, was distributed during the AITRO National Congress 2024 and via social media for two additional weeks. Data were analyzed using descriptive statistics and non-parametric tests.</div></div><div><h3>Results</h3><div>A total of 191 valid responses were collected with median age of 38 years and balanced geographical representation across Italy. Only 14.7 % had attended sustainability-focused training, and 17.8 % had participated in related events. The overall knowledge level on sustainability was moderate (median = 3/5), with 38.2 % reporting limited knowledge. A significant association was found between attending sustainability sessions and higher knowledge scores (p &lt; 0.05). Sustainable initiatives were reported by 41.9 % of respondents, with slightly higher adoption in Northern centers. Barriers to implementation included insufficient training and lack of structured guidance.</div></div><div><h3>Conclusions</h3><div>Italian RTTs demonstrate moderate awareness of sustainability, with limited training and heterogeneous adoption of sustainable practices. These findings highlight the need for structured educational programs, enhanced interprofessional awareness, and institutional support. Scientific Association such as AITRO can play a pivotal role in promoting and fostering sustainability policies in radiotherapy.</div></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"37 ","pages":"Article 100360"},"PeriodicalIF":2.8,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145697938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gathering evidence on preparation for advanced practice in radiation therapy: An international focus group synthesis","authors":"Yat Tsang ,&nbsp;Samantha Skubish ,&nbsp;Maria Dimopoulos ,&nbsp;Nicole Harnett ,&nbsp;Caitlin Gillan","doi":"10.1016/j.tipsro.2025.100361","DOIUrl":"10.1016/j.tipsro.2025.100361","url":null,"abstract":"<div><h3>Purpose</h3><div>Advanced Practice Radiation Therapist (APRT) roles are expanding globally, yet educational preparation approaches vary significantly across jurisdictions. This study synthesized key multidisciplinary interest-holder perspectives to identify essential considerations for APRT preparation.</div></div><div><h3>Methods and Materials</h3><div>Focus group interviews were conducted via videoconferencing, including practicing APRTs, gatekeepers, educators, and institutional radiation oncology leaders. Semi-structured discussions explored educational content, clinical training, assessment methods, and implementation factors. Data underwent inductive thematic analysis utilizing Braun and Clarke’s six-step approach, followed by concept mapping to organize findings into an integrated thematic structure.</div></div><div><h3>Results</h3><div>Four focus group sessions involving 33 participants from ten countries across North America, Europe, Asia, and Australia were conducted between October 2024 and January 2025. Five interconnected themes representing key considerations for APRT preparation emerged: (1) content of educational preparation including the four APRT pillars of clinical practice, research, leadership, and education; (2) aligning preparation outcomes with the intended scope of practice, particularly autonomous decision-making and critical thinking; (3) integrating diverse learning processes combining traditional knowledge acquisition with experiential clinical training; (4) key requirements for preparation, including master’s-level education and structured clinical apprenticeship under direct supervision; and (5) critical influence of broader system context on transportability and sustainability across healthcare environments. Participants endorsed master’s-level academic preparation combined with extensive clinical experience, drawing parallels to physician training where apprenticeship builds specialist competencies beyond formal academics.</div></div><div><h3>Conclusions</h3><div>This internationally derived, multidisciplinary interest-holder synthesis provides foundational guidance for APRT curriculum development, competency standards, and professional credentialing. While these findings offer important direction for standardizing preparation approaches, future research involving broader multidisciplinary interest-holder groups, implementation studies, and outcomes evaluation is necessary to validate and extend these preliminary findings.</div></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"36 ","pages":"Article 100361"},"PeriodicalIF":2.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145681089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multi-institutional virtual peer review for reirradiation: dedicated workflow and one-year results","authors":"M. Ayadi ,&nbsp;P. Dupuis ,&nbsp;M. Sandt ,&nbsp;G. Beldjoudi ,&nbsp;A. Serre ,&nbsp;I. Martel-Lafay ,&nbsp;L. Claude ,&nbsp;V. Guimas ,&nbsp;S. Chiavassa ,&nbsp;A. Moignier ,&nbsp;A. Alexis ,&nbsp;L. Ollivier ,&nbsp;L. Vaugier ,&nbsp;M. Lange ,&nbsp;C. Moncharmont ,&nbsp;M.P. Sunyach","doi":"10.1016/j.tipsro.2025.100357","DOIUrl":"10.1016/j.tipsro.2025.100357","url":null,"abstract":"<div><div>This study reports one-year results from multidisciplinary and multi-institutional virtual peer review meetings for reirradiation cases. A dedicated workflow supported collaborative decision-making, especially for complex treatments, and guided dose prescriptions and cumulative dose evaluations. The indication of reRT was disapproved for 19% of the cases, while the reRT dose prescription was suggested or modified for 45% of the validated indications. Results confirm feasibility and clinical value, fostering safer and more standardized reirradiation practices across institutions.</div></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"36 ","pages":"Article 100357"},"PeriodicalIF":2.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145614419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of upright immobilization methods for abdominal and head-and-neck cancer treatments in a carbon ion radiotherapy setting","authors":"Maria Varnava ,&nbsp;Motohiro Kawashima ,&nbsp;Akihiko Matsumura ,&nbsp;Yoshiaki Oohashi ,&nbsp;Makoto Miyazawa ,&nbsp;Junichi Koya ,&nbsp;Naoto Yamaguchi ,&nbsp;Tomoaki Ogano ,&nbsp;Mutsumi Tashiro ,&nbsp;Tatsuya Ohno","doi":"10.1016/j.tipsro.2025.100356","DOIUrl":"10.1016/j.tipsro.2025.100356","url":null,"abstract":"<div><h3>Background and Purpose</h3><div>Upright patient positioning is an emerging approach in radiotherapy that may overcome current limitations in carbon ion radiotherapy (CIRT). This study evaluated upright immobilization techniques for abdominal and head-and-neck (HN) cancers in a CIRT setting.</div></div><div><h3>Materials and Methods</h3><div>Ten volunteers were positioned on the Chair, a demo upright positioning system (Leo Cancer Care, USA). Three setups were evaluated: no immobilization devices, vacuum bags alone (ESFORM; Engineering System Co., Japan), and vacuum bags with a thermoplastic shell (Shellfitter; Kuraray Trading Co., Japan), called the “shell” setup. Interfractional and intrafractional errors were assessed using skin markers drawn on the abdominal and HN areas. Interfractional shifts per direction and Euclidean distances were calculated by comparing reference and repeated images. Intrafractional shifts per direction and Euclidean distances were calculated from images acquired over a 15-min period. Also, volunteers rated their comfort for each setup on a scale of 1–5. Differences in the interfractional and intrafractional motion, and comfort ratings between the three setups were investigated.</div></div><div><h3>Results</h3><div>Significant differences (<em>p</em> &lt; 0.05) in the interfractional Euclidean distances were observed between the three setups in both anatomical areas, while significant differences were observed in more shifts per direction in the abdominal case. The “shell” setup minimized intrafractional distances. No significant differences were observed in the comfort ratings between the setups.</div></div><div><h3>Conclusion</h3><div>Upright positioning in CIRT appears feasible. Further research is needed to refine immobilization techniques to support clinical implementation of upright positioning in CIRT.</div></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"36 ","pages":"Article 100356"},"PeriodicalIF":2.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145614331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inter-Observer variability in organs at risk contouring among radiation therapy students and qualified radiation therapists","authors":"Crispen Chamunyonga ,&nbsp;Kerrie Mengersen ,&nbsp;Catriona Hargrave","doi":"10.1016/j.tipsro.2025.100362","DOIUrl":"10.1016/j.tipsro.2025.100362","url":null,"abstract":"<div><h3>Introduction</h3><div>Contouring organ-at-risk structures (OARs) remains an important skill that must be developed through education and training. This study assessed variations in OAR contouring among undergraduate radiation therapy students and qualified radiation therapists (RTs).</div></div><div><h3>Methods</h3><div>Four planning computed tomography datasets (Brain, Lung, Parotid, and Prostate), which included 21 clinician-validated OAR contours, were utilised as references in this contouring study. Participants included 2nd to 4th year students, as well as qualified RTs. A quantitative comparison of contours was performed using the Dice Similarity Coefficient (DICE) and Hausdorff distance (HD) metrics. Statistical analyses assessed variations across structures, tumour sites, experience levels, and contouring methods.</div></div><div><h3>Results</h3><div>A total of 440 OAR contours were analysed. The bladder and lung OARs achieved the highest mean DICE scores (&gt;0.9), while structures such as the brainstem, heart, and parotid gland exhibited mean DICE scores between 0.76 and 0.89. Smaller structures, such as the lens, demonstrated very low HD95 values. A moderate positive correlation (r = 0.591) was observed between OAR volume and DICE scores (&lt;200 cc). Statistical analyses indicated significant differences across tumour sites (P &lt; 0.001 for DICE, HDavg, HD95, and HDmax). The comparison of manual and guided contouring showed statistically significant differences only for DICE (P &lt; 0.001) and HDmax (P = 0.004). There were no significant differences in median scores between students and qualified groups. However, students exhibited higher variance than qualified professionals.</div></div><div><h3>Conclusion</h3><div>This study highlighted OARs that are challenging to contour or edit, suggesting the need for a comprehensive educational framework.</div></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"36 ","pages":"Article 100362"},"PeriodicalIF":2.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145681090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}