Development of a contouring guide in three different head set-ups for hippocampal sparing radiotherapy: a practical approach

Biase, S. Di; Trignani, Marianna; Caravatta, L.; Voicu, Ioan Paul; Carlo, C. Di; Vinciguerra, A.; Augurio, Antonietta; Perrotti, Francesca; Panara, Valentina; Genovesi, Domenico

doi:10.1007/s11547-017-0775-1

Cited by 3 publications

(2 citation statements)

References 16 publications

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“…Finally, Di Biase et al showed that the head position on the treatment table can affect hippocampal appearance. To solve the problem, they developed a practical guide for hippocampus delineation based on three different head position setups [42].…”

Section: Discussionmentioning

confidence: 99%

Inter-observer variation of hippocampus delineation in hippocampal avoidance prophylactic cranial irradiation

et al. 2018

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Section: Discussionmentioning

confidence: 99%

Inter-observer variation of hippocampus delineation in hippocampal avoidance prophylactic cranial irradiation

et al. 2018

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“…Furthermore, gadolinium, an MRI contrast medium, provides better localization as before of the choroid plexus, one of the anatomic areas of the hippocampus. Therefore, use of both sequences, with and without MRI T1 contrast, may contribute to a more precise delineation of the hippocampus [30,35,39]. To date, the T1 MRI sequence without contrast enhancement is the most frequently used in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

The Learning Curve and Inter-Observer Variability in Contouring the Hippocampus under the Hippocampal Sparing Guidelines of Radiation Therapy Oncology Group 0933

et al. 2022

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Hippocampal-sparing brain radiotherapy (HS-BRT) in cancer patients results in preservation of neurocognitive function after brain RT which can contribute to patients’ quality of life (QoL). The crucial element in HS-BRT treatment planning is appropriate contouring of the hippocampus. Ten doctors delineated the left and right hippocampus (LH and RH, respectively) on 10 patients’ virtual axial images of brain CT fused with T1-enhanced MRI (1 mm) according to the RTOG 0933 atlas recommendations. Variations in the spatial localization of the structure were described in three directions: right–left (X), cranio-caudal (Y), and forward–backward (Z). Discrepancies concerned three-dimensional localization, shape, volume and size of the hippocampus. The largest differences were observed in the first three delineated cases which were characterized by larger hippocampal volumes than the remaining seven cases. The volumes of LH of more than half of hippocampus contours were marginally bigger than those of RH. Most differences in delineation of the hippocampus were observed in the area of the posterior horn of the lateral ventricle. Conversely, a large number of hippocampal contours overlapped near the brainstem and the anterior horn of the lateral ventricle. The most problematic area of hippocampal contouring is the posterior horn of the lateral ventricle. Training in the manual contouring of the hippocampus during HS-BRT treatment planning under the supervision of experienced radiation oncologists is necessary to achieve optimal outcomes. This would result in superior outcomes of HS-BRT treatment and improvement in QoL of patients compared to without HS-BRT procedure. Correct delineation of the hippocampus is problematic. This study demonstrates difficulties in HS-BRT treatment planning and highlights critical points during hippocampus delineation.

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Parotid gland dose reduction in the hippocampus avoidance whole-brain radiotherapy using helical tomotherapy

Shimizu¹,

Sasaki²,

Aoyama³

et al. 2021

Journal of Radiation Research

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The present study aimed to reduce the parotid gland dose in the hippocampus avoidance with whole-brain radiotherapy (HA-WBRT) using the helical tomotherapy (HT). Ten patients who had previously undergone WBRT were randomly selected and enrolled in this study. During the treatment planning, two different techniques to the jaw were applied for each patient, namely, 1.0 cm fixed jaw and 2.5 cm dynamic jaw. To efficiently reduce the dose in the bilateral parotid glands, directional block (DB) mode was set. The DB is a function of a treatment planning system for the dose reduction in organs at risk. The standard HA-WBRT plan which did not reduce the parotid gland dose was also designed to compare the plan quality. Compared with the standard HA-WBRT plan, the parotid gland dose could be reduced by approximately 70% without extending the delivery time by adding the parotid gland on the DB mode to the dose constraint. In addition, the differences in dosimetric parameters observed between the plans employing the 1.0 cm fixed jaw and 2.5 cm dynamic jaw were almost negligible. Moreover, delivery time in the 2.5 cm dynamic jaw could be greatly reduced by 60% compared with that in the 1.0 cm fixed jaw.

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Development of a contouring guide in three different head set-ups for hippocampal sparing radiotherapy: a practical approach

Abstract: Our guide can represent a useful tool for hippocampal delineation in clinical practice and for different anatomic variations due to different head positions. Certainly, it should be validated in practice.

Cited by 3 publications

References 16 publications

Inter-observer variation of hippocampus delineation in hippocampal avoidance prophylactic cranial irradiation

Inter-observer variation of hippocampus delineation in hippocampal avoidance prophylactic cranial irradiation

The Learning Curve and Inter-Observer Variability in Contouring the Hippocampus under the Hippocampal Sparing Guidelines of Radiation Therapy Oncology Group 0933

Parotid gland dose reduction in the hippocampus avoidance whole-brain radiotherapy using helical tomotherapy

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