Magnetic Resonance Imaging–Based Delineation of Organs at Risk in the Head and Neck Region

Paczona, Viktor; Capala, Marta E.; Deák-Karancsi, Borbála; Borzási, Emőke; Végváry, Zoltán; Kelemen, Gyöngyi; Kószó, Renáta; Ruskó, László; Ferenczi, Lehel; Verduijn, Gerda M.; Петит, С.; Oláh, Judit; Cserháti, Adrienn; Hideghéty, Katalin

doi:10.1016/j.adro.2022.101042

Cited by 7 publications

(9 citation statements)

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“…Details of salivary gland anatomy have been determined through cadaveric dissection, review of static imaging (CT/MRI), and analysis of surgical specimens. [41][42][43][44][45][46][47] Dynamic ultrasound imaging offers an alternate perspective with advantages and limitations that warrant consistency in assessment and reporting. 48 The value in assessing salivary gland dimensions to help determine the impact of treatment is emphasized in the EULAR Sjogren's Syndrome Disease Activity Index (ESSDAI) as reported in 2010.…”

Section: Discussionmentioning

confidence: 99%

“…Details of salivary gland anatomy have been determined through cadaveric dissection, review of static imaging (CT/MRI), and analysis of surgical specimens. 41 , 42 , 43 , 44 , 45 , 46 , 47 Dynamic ultrasound imaging offers an alternate perspective with advantages and limitations that warrant consistency in assessment and reporting. 48 …”

Section: Discussionmentioning

confidence: 99%

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Proposal for standardized ultrasound analysis of the salivary glands: Part 1 submandibular gland

Hoffman,

Koch,

Witt

et al. 2024

Laryngoscope Investig Oto

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ObjectivesThe Salivary Gland Committee of the American Academy of Otolaryngology‐Head and Neck Surgery seeks to standardize terminology and technique for ultrasonograpy used in the evaluation and treatment of salivary gland disorders.MethodsDevelopment of expert opinion obtained through interaction with international practitioners representing multiple specialties. This committee work includes a comprehensive literature review with presentation of case examples to propose a standardized protocol for the language used in ultrasound salivary gland assessment.ResultsA multiple segment proposal is initiated with this focus on the submandibular gland. We provide a concise rationale for recommended descriptive language highlighted by a more extensive supplement that includes an extensive literature review with additional case examples.ConclusionRecommendations are provided to improve consistency both in performing and reporting submandibular gland ultrasound.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Proposal for standardized ultrasound analysis of the salivary glands: Part 1 submandibular gland

Hoffman,

Koch,

Witt

et al. 2024

Laryngoscope Investig Oto

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“…10 However, even if guidelines are followed, manual contouring is still biased by the subjective interpretation of the observer, and therefore it is strongly recommended to perform basic observer training with joint delineation review sessions, 7 and to include additional modalities to improve the visibility of structure boundaries. 6 By considering the emerging role of the MR modality in RT 33 and its value for OAR contouring, 48 in this study we performed a variability analysis of OAR contouring in the HaN region from CT and MR images of the same patients.…”

Section: Discussionmentioning

confidence: 99%

“…The MR modality has been long recognized as valuable for contouring OARs in the HaN region, [45][46][47][48] however, to the best of our knowledge, the accuracy and consistency of the resulting OAR contours have not been yet objectively evaluated. In this study, we therefore analyze the interobserver and intermodality variability of manual contouring of up to 31 OARs in the HaN region, performed by observers with different level of experience from CT and MR images of the same patients.Besides providing valuable insights to the levels of both interobserver and intermodality variability from the perspective of manual OAR contouring, the obtained results can be also viewed as a baseline for an objective evaluation of methods for auto-segmentation of OARs in the HaN region, 31 which have been rapidly evolving during the past decade due to the integration of artificial intelligence, and received a considerable boost in performance due to the advances in deep learning.…”

Section: Introductionmentioning

confidence: 99%

“…The MR modality has been long recognized as valuable for contouring OARs in the HaN region, 45–48 however, to the best of our knowledge, the accuracy and consistency of the resulting OAR contours have not been yet objectively evaluated. In this study, we therefore analyze the interobserver and intermodality variability of manual contouring of up to 31 OARs in the HaN region, performed by observers with different level of experience from CT and MR images of the same patients.…”

Section: Introductionmentioning

confidence: 99%

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vOARiability: Interobserver and intermodality variability analysis in OAR contouring from head and neck CT and MR images

Podobnik,

Ibragimov,

Peterlin

et al. 2024

Medical Physics

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BackgroundAccurate and consistent contouring of organs‐at‐risk (OARs) from medical images is a key step of radiotherapy (RT) cancer treatment planning. Most contouring approaches rely on computed tomography (CT) images, but the integration of complementary magnetic resonance (MR) modality is highly recommended, especially from the perspective of OAR contouring, synthetic CT and MR image generation for MR‐only RT, and MR‐guided RT. Although MR has been recognized as valuable for contouring OARs in the head and neck (HaN) region, the accuracy and consistency of the resulting contours have not been yet objectively evaluated.PurposeTo analyze the interobserver and intermodality variability in contouring OARs in the HaN region, performed by observers with different level of experience from CT and MR images of the same patients.MethodsIn the final cohort of 27 CT and MR images of the same patients, contours of up to 31 OARs were obtained by a radiation oncology resident (junior observer, JO) and a board‐certified radiation oncologist (senior observer, SO). The resulting contours were then evaluated in terms of interobserver variability, characterized as the agreement among different observers (JO and SO) when contouring OARs in a selected modality (CT or MR), and intermodality variability, characterized as the agreement among different modalities (CT and MR) when OARs were contoured by a selected observer (JO or SO), both by the Dice coefficient (DC) and 95‐percentile Hausdorff distance (HD95).ResultsThe mean (±standard deviation) interobserver variability was 69.0 ± 20.2% and 5.1 ± 4.1 mm, while the mean intermodality variability was 61.6 ± 19.0% and 6.1 ± 4.3 mm in terms of DC and HD95, respectively, across all OARs. Statistically significant differences were only found for specific OARs. The performed MR to CT image registration resulted in a mean target registration error of 1.7 ± 0.5 mm, which was considered as valid for the analysis of intermodality variability.ConclusionsThe contouring variability was, in general, similar for both image modalities, and experience did not considerably affect the contouring performance. However, the results indicate that an OAR is difficult to contour regardless of whether it is contoured in the CT or MR image, and that observer experience may be an important factor for OARs that are deemed difficult to contour. Several of the differences in the resulting variability can be also attributed to adherence to guidelines, especially for OARs with poor visibility or without distinctive boundaries in either CT or MR images. Although considerable contouring differences were observed for specific OARs, it can be concluded that almost all OARs can be contoured with a similar degree of variability in either the CT or MR modality, which works in favor of MR images from the perspective of MR‐only and MR‐guided RT.

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The Use of Magnetic Resonance Imaging in Radiation Therapy Treatment Simulation and Planning

McGee,

Cao,

Das

et al. 2024

Magnetic Resonance Imaging

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Ever since its introduction as a diagnostic imaging tool the potential of magnetic resonance imaging (MRI) in radiation therapy (RT) treatment simulation and planning has been recognized. Recent technical advances have addressed many of the impediments to use of this technology and as a result have resulted in rapid and growing adoption of MRI in RT. The purpose of this article is to provide a broad review of the multiple uses of MR in the RT treatment simulation and planning process, identify several of the most used clinical scenarios in which MR is integral to the simulation and planning process, highlight existing limitations and provide multiple unmet needs thereby highlighting opportunities for the diagnostic MR imaging community to contribute and collaborate with our oncology colleagues.Evidence Level5Technical EfficacyStage 5

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Magnetic Resonance Imaging–Based Delineation of Organs at Risk in the Head and Neck Region

Cited by 7 publications

References 46 publications

Proposal for standardized ultrasound analysis of the salivary glands: Part 1 submandibular gland

Proposal for standardized ultrasound analysis of the salivary glands: Part 1 submandibular gland

vOARiability: Interobserver and intermodality variability analysis in OAR contouring from head and neck CT and MR images

The Use of Magnetic Resonance Imaging in Radiation Therapy Treatment Simulation and Planning

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