Evaluation of therapeutic radiographer target volume contouring for magnetic resonance image guided online adaptive bladder radiotherapy
Background and purpose: One barrier to wider clinical implementation of online MRI-guided radiotherapy (MRIgRT) on the MR Linac (MRL) is resource intensity. Specifically, the requirement for a clinical oncologist/radiation oncologist (CO/RO) to perform online contouring each fraction. We report an e...
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Elsevier
2025-09-01
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| Series: | Clinical and Translational Radiation Oncology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405630825000862 |
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| author | Bethany Williams Jonathan Mohajer Sophie E. Alexander Helen Barnes Francis Casey Joan Chick Alex Dunlop Ryan Fullerton Trina Herbert Robert Huddart Sarah A. Mason Adam Mitchell Jayde Nartey Simeon Nill Priyanka Patel Shaista Hafeez Helen A. McNair |
| author_facet | Bethany Williams Jonathan Mohajer Sophie E. Alexander Helen Barnes Francis Casey Joan Chick Alex Dunlop Ryan Fullerton Trina Herbert Robert Huddart Sarah A. Mason Adam Mitchell Jayde Nartey Simeon Nill Priyanka Patel Shaista Hafeez Helen A. McNair |
| author_sort | Bethany Williams |
| collection | DOAJ |
| description | Background and purpose: One barrier to wider clinical implementation of online MRI-guided radiotherapy (MRIgRT) on the MR Linac (MRL) is resource intensity. Specifically, the requirement for a clinical oncologist/radiation oncologist (CO/RO) to perform online contouring each fraction. We report an evaluation of therapeutic radiographer (RTT) online contouring for patients receiving whole bladder MRIgRT. Materials and methods: RTTs undertook a contouring training programme. RTT and CO/RO clinical target volume (CTV) contours from 95 fractions were assessed using dice similarity coefficient (DSC), hausdorff distance (HD), mean distance to agreement (MDA), sensitivity and specificity volume metrics on the Raystation treatment planning system (TPS) (RaySearch Laboratories). Additionally, CTV DSC was evaluated with respect to a simultaneous truth and performance level estimation (STAPLE) generated in ADMIRE (Elekta AB, Stockholm, Sweden). In dosimetric analysis (Monaco, Elekta AB), online adaptive treatment plans, which had been generated using RTT-defined contours, were evaluated using contours delineated offline by CO/ROs. Results: Comparison of RTT versus CO/RO contours found the CTV median (interquartile range) (IQR) for DSC was 0.92 (0.91–0.94), MDA was 0.11 (0.09–0.12) cm, and HD was 0.63 (0.53–0.72) cm, sensitivity and specificity were 0.94 (0.90–0.96) and 0.95 (0.92–0.97) respectively. In dosimetric analysis, 65 % (30/46) plans met optimal PTV coverage of V52.25 Gy > 98 % and all plans met mandatory PTV coverage of V52.25 Gy > 95 %. Conclusion: Following effective training, evaluation results demonstrate RTT whole bladder CTV contours to be comparable to CO/RO contours. Clinical implementation will release CO/ROs from MRL bladder treatments, reducing resource intensity of online workflows. |
| format | Article |
| id | doaj-art-4485fa8f6fa1404ab72d54155dc5dd5f |
| institution | DOAJ |
| issn | 2405-6308 |
| language | English |
| publishDate | 2025-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Clinical and Translational Radiation Oncology |
| spelling | doaj-art-4485fa8f6fa1404ab72d54155dc5dd5f2025-08-20T02:55:20ZengElsevierClinical and Translational Radiation Oncology2405-63082025-09-015410099410.1016/j.ctro.2025.100994Evaluation of therapeutic radiographer target volume contouring for magnetic resonance image guided online adaptive bladder radiotherapyBethany Williams0Jonathan Mohajer1Sophie E. Alexander2Helen Barnes3Francis Casey4Joan Chick5Alex Dunlop6Ryan Fullerton7Trina Herbert8Robert Huddart9Sarah A. Mason10Adam Mitchell11Jayde Nartey12Simeon Nill13Priyanka Patel14Shaista Hafeez15Helen A. McNair16The Royal Marsden NHS Foundation Trust, London, UK; Corresponding author at: Radiotherapy, The Royal Marsden, Downs Road, Sutton, Surrey SM2 5PT, UK.The Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, UKThe Royal Marsden NHS Foundation Trust, London, UKThe Royal Marsden NHS Foundation Trust, London, UKThe Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, UKThe Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, UKThe Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, UKThe Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, UKThe Royal Marsden NHS Foundation Trust, London, UKThe Institute of Cancer Research/The Royal Marsden NHS Foundation Trust, London, UKThe Institute of Cancer Research/The Royal Marsden NHS Foundation Trust, London, UKThe Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, UKThe Royal Marsden NHS Foundation Trust, London, UKThe Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, UKThe Royal Marsden NHS Foundation Trust, London, UKThe Institute of Cancer Research/The Royal Marsden NHS Foundation Trust, London, UKThe Institute of Cancer Research/The Royal Marsden NHS Foundation Trust, London, UKBackground and purpose: One barrier to wider clinical implementation of online MRI-guided radiotherapy (MRIgRT) on the MR Linac (MRL) is resource intensity. Specifically, the requirement for a clinical oncologist/radiation oncologist (CO/RO) to perform online contouring each fraction. We report an evaluation of therapeutic radiographer (RTT) online contouring for patients receiving whole bladder MRIgRT. Materials and methods: RTTs undertook a contouring training programme. RTT and CO/RO clinical target volume (CTV) contours from 95 fractions were assessed using dice similarity coefficient (DSC), hausdorff distance (HD), mean distance to agreement (MDA), sensitivity and specificity volume metrics on the Raystation treatment planning system (TPS) (RaySearch Laboratories). Additionally, CTV DSC was evaluated with respect to a simultaneous truth and performance level estimation (STAPLE) generated in ADMIRE (Elekta AB, Stockholm, Sweden). In dosimetric analysis (Monaco, Elekta AB), online adaptive treatment plans, which had been generated using RTT-defined contours, were evaluated using contours delineated offline by CO/ROs. Results: Comparison of RTT versus CO/RO contours found the CTV median (interquartile range) (IQR) for DSC was 0.92 (0.91–0.94), MDA was 0.11 (0.09–0.12) cm, and HD was 0.63 (0.53–0.72) cm, sensitivity and specificity were 0.94 (0.90–0.96) and 0.95 (0.92–0.97) respectively. In dosimetric analysis, 65 % (30/46) plans met optimal PTV coverage of V52.25 Gy > 98 % and all plans met mandatory PTV coverage of V52.25 Gy > 95 %. Conclusion: Following effective training, evaluation results demonstrate RTT whole bladder CTV contours to be comparable to CO/RO contours. Clinical implementation will release CO/ROs from MRL bladder treatments, reducing resource intensity of online workflows.http://www.sciencedirect.com/science/article/pii/S2405630825000862Online adaptive bladder radiotherapyMR LinacRTT contouring |
| spellingShingle | Bethany Williams Jonathan Mohajer Sophie E. Alexander Helen Barnes Francis Casey Joan Chick Alex Dunlop Ryan Fullerton Trina Herbert Robert Huddart Sarah A. Mason Adam Mitchell Jayde Nartey Simeon Nill Priyanka Patel Shaista Hafeez Helen A. McNair Evaluation of therapeutic radiographer target volume contouring for magnetic resonance image guided online adaptive bladder radiotherapy Clinical and Translational Radiation Oncology Online adaptive bladder radiotherapy MR Linac RTT contouring |
| title | Evaluation of therapeutic radiographer target volume contouring for magnetic resonance image guided online adaptive bladder radiotherapy |
| title_full | Evaluation of therapeutic radiographer target volume contouring for magnetic resonance image guided online adaptive bladder radiotherapy |
| title_fullStr | Evaluation of therapeutic radiographer target volume contouring for magnetic resonance image guided online adaptive bladder radiotherapy |
| title_full_unstemmed | Evaluation of therapeutic radiographer target volume contouring for magnetic resonance image guided online adaptive bladder radiotherapy |
| title_short | Evaluation of therapeutic radiographer target volume contouring for magnetic resonance image guided online adaptive bladder radiotherapy |
| title_sort | evaluation of therapeutic radiographer target volume contouring for magnetic resonance image guided online adaptive bladder radiotherapy |
| topic | Online adaptive bladder radiotherapy MR Linac RTT contouring |
| url | http://www.sciencedirect.com/science/article/pii/S2405630825000862 |
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