Development and initial evaluation of a novel 3D volumetric outlining system

Minimal point volumetric outlining and editing for radiotherapy treatment planning

Purpose

A novel radiotherapy outlining application uses a small number of user-assigned points across orthogonal planes to generate a mesh which is then edited across multiple slices using innovative three-dimensional (3D) sculpting tools. This paper presents the results of a bladder outlining study that compared times and volumes for the new tool with those of a conventional manual outlining tool.

Materials and methods

All students undertaking their first University radiotherapy planning module were invited to participate. Following training, they performed a timed outlining of the same male bladder dataset and provided feedback on their preferred method.

Results

Comparison of times from the resulting ten datasets demonstrated that the 3D segmentation tool was significantly faster than conventional software with a mean time of 11·9 minutes compared with 19·2 minutes (p=0·03). The users expressed a preference for the new tool (eight users) over the conventional outlining software (two users).

Conclusions

A minimal point 3D volumetric manual outlining tool utilising orthogonal computed tomography planes demonstrated significant time saving for bladder segmentation compared with axial-based outlining within a group of novice outliners. Future work aims to establish the role of the 3D multi-slice sculpting tools in editing of auto-segmentation derived contour sets.

What are the current and future requirements for magnetic resonance imaging interpretation skills in radiotherapy? A critical review

Purpose

Increasing usage of magnetic resonance imaging (MRI) in radiotherapy (RT) and the advent of MRI-based image-guided radiotherapy (IGRT) suggests a need for additional training within the RT profession. This critical review aimed to identify potential gaps in knowledge by evaluating the current skill base in MRI among therapeutic radiographers as evidenced by published research.

Methods

Papers related to MRI usage were retrieved. Topic areas included outlining, planning and IGRT; diagnosis, follow-up and staging-related papers were excluded. After selection and further text analysis, papers were grouped by tumour site and year of publication.

Results

The literature search and filtering resulted in a total of 123 papers, of which 66 were related to ‘outlining’, 37 to ‘planning’ and 20 to ‘IGRT’. The main sites of existing MRI expertise in RT were brain, central nervous system, prostate, and head and neck tumours. Expertise was clearly related to regions where MRI offered improved soft-tissue contrast. MRI studies within RT have been published from 2007 onwards at a steadily increasing rate.

Conclusion

Current use of MRI in RT is mainly restricted to sites where MRI offers a considerable imaging advantage over computed tomography. Given the changing use of MRI for image guidance, emerging therapeutic radiographers will require training in MRI interpretation across a wider range of anatomical regions.