Cited by 308Advanced Radiotherapy TechniquesMedical Image Segmentation TechniquesRadiation Dose and Imaging

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A cardiac contouring atlas for radiotherapy

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Duane, Frances, Aznar, Marianne C., Bartlett, Freddie, Cutter, David J., Darby, Sarah C., Jagsi, Reshma, Lorenzen, Ebbe L., McArdle, Orla, McGale, Paul, Myerson, Saul, Rahimi, Kazem, Vivekanandan, Sindu, Warren, Samantha, Taylor, Carolyn W.·2017·Radiotherapy and Oncology

DOI 10.1016/j.radonc.2017.01.008PMC PMC5356506

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Abstract

Background and purpose The heart is a complex anatomical organ and contouring the cardiac substructures is challenging. This study presents a reproducible method for contouring left ventricular and coronary arterial segments on radiotherapy CT-planning scans. Material and methods Segments were defined from cardiology models and agreed by two cardiologists. Reference atlas contours were delineated and written guidelines prepared. Six radiation oncologists tested the atlas. Spatial variation was assessed using the DICE similarity coefficient (DSC) and the directed Hausdorff average distance ( d → H , avg ). The effect of spatial variation on doses was assessed using six different breast cancer regimens. Results The atlas enabled contouring of 15 cardiac segments. Inter-observer contour overlap (mean DSC) was 0.60–0.73 for five left ventricular segments and 0.10–0.53 for ten coronary arterial segments. Inter-observer contour separation (mean d → H , avg ) was 1.5–2.2mm for left ventricular segments and 1.3–5.1mm for coronary artery segments. This spatial variation resulted in <1Gy dose variation for most regimens and segments, but 1.2–21.8Gy variation for segments close to a field edge. Conclusions This cardiac atlas enables reproducible contouring of segments of the left ventricle and main coronary arteries to facilitate future studies relating cardiac radiation doses to clinical outcomes.

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Authors: Duane, F., Aznar, M. C., Bartlett, F., Cutter, D. J., Darby, S. C., Jagsi, R., Lorenzen, E. L., McArdle, O., McGale, P., Myerson, S., Rahimi, K., Vivekanandan, S., Warren, S., & Taylor, C. W.
Affiliations: University of Oxford (GB)
Queen Alexandra Hospital (GB)
University of Michigan (US)
Odense University Hospital (DK)
St. Luke's Hospital (IE)
The George Institute for Global Health (GB)
University of Birmingham (GB)
Corresponding author: Duane, Frances
ORCID: Duane, Frances
Aznar, Marianne C.
Cutter, David J.
Darby, Sarah C.
Jagsi, Reshma
Lorenzen, Ebbe L.
McGale, Paul
Myerson, Saul
Rahimi, Kazem
Taylor, Carolyn W.
Venue: Radiotherapy and Oncology
Publisher: Elsevier BV
Published: 2017-03
Volume: 122
Issue: 3
Pages: 416-422
ISSN: 0167-8140 (ISSN-L)
DOI: 10.1016/j.radonc.2017.01.008
PMC: PMC5356506
OpenAlex: W2591100698
Cited by: 308
References: 24
Citations by year: 2026: 31 · 2025: 32 · 2024: 44 · 2023: 35 · 2022: 44 · 2021: 43 · 2020: 35 · 2019: 19 · 2018: 22 · 2017: 3
FWCI: 20.37
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
creativecommons.org/licenses/by/4.0/ (vor)
Locations: Radiotherapy and Oncology (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
University of Southern Denmark Research Portal (University of Southern Denmark) (submittedVersion, cc-by)
Research Explorer (The University of Manchester) (submittedVersion, cc-by)
Funders: Medical Research Council
Cancer Research UK (C8225/A21133, RE/13/1/30181, C5255/A15935)
British Heart Foundation Centre for Research Excellence
National Institute for Health Research
Topics: Physical Sciences › Physics and Astronomy › Radiation › Advanced Radiotherapy Techniques
Physical Sciences › Computer Science › Computer Vision and Pattern Recognition › Medical Image Segmentation Techniques
Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiation Dose and Imaging
Keywords: left ventricle segmentation, coronary artery segmentation, cardiac radiotherapy, breast cancer radiotherapy, heart dose
MeSH terms: Breast Neoplasms, Coronary Vessels, Female, Heart, Heart Ventricles, Humans, Radiotherapy Planning, Computer-Assisted, Tomography, X-Ray Computed

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