Conclusion:We proposed a multi-task deep learning method with distancebased decision stratification to effectively detect and segment the GTV_LN in esophageal cancer radiotherapy. It significantly improves on previous state-of-the-art and the achieved performance has potential clinical values considering the large multi-user variability in this challenging task.
The study assessed the effectiveness of a site-specific video educational material in improving patient understanding and confidence regarding radiation therapy trajectory. Methods and Materials: A quasi experimental longitudinal pretest posttest study was conducted at a referral radiation therapy center from May 2020 to September 2020. It included 52 adult patients admitted for a first course radical radiation therapy. One generic and 6 site-specific (breast, pelvis, head and neck, brain, chest and abdomen, and bladder) animated cartoon videos were developed in house to provide concise overview of the overall patient's trajectory in radiation therapy, with full visual description of the procedures and specific preparation measures. A 14-item questionnaire was designed to assess pre-and postintervention levels of understanding and confidence of patients, with calculation of and an understanding and confidence score (UCS), range 0-14. Results: The mean (standard deviation) UCS in pre-and postintervention was 9.36 (2.48) and 11.92 (1.34) out of 14, respectively, indicating a mean increase of 2.57 subsequent to the intervention (P < .001). The effect size was large with a Cohen's d = 1.01. Of the 14 dimensions explored, 8 were observed to have remarkable improvement, notably understanding the purpose of the tattoo mark, reason of daily or weekly imaging, and what to expect with radiation therapy. Participants with poor reading ability had greater increase in UCS (DUCS = 4.25 vs ≤2.33) and in 5 out of 8 dimensions with remarkable improvement. Conclusions: The use of digital educational material in radiation oncology meets the urgent need for providing patients with concise and site-specific information, while sparing extra hospital visits to meet education coordinators during the COVID-19 crisis. Additional studies are warranted to assess both the clinical and long-term effectiveness of the educational material, using a longitudinal controlled design.
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