2021 ASM / R-0367
Clinical Evaluation of RTOG-atlas based contouring, MRI-atlas auto-contouring, and neuro-radiologist contouring of the hippocampi for hippocampal avoidance whole-brain radiotherapy
Keywords:
CNS, MR, Radiation therapy / Oncology, Technology assessment, Quality assurance
Authors:
H. Lo, E. S. Choong, R. Tse, G. Harris, L. van Camp, P. Estoesta, E. R. Claridge Mackonis; Camperdown, NSW/AU
DOI:
10.26044/ranzcr2021/R-0367
Purpose
RTOG 0933 reported significant benefit in memory preservation and quality of life as compared to historical controls in using hippocampal-avoidance whole brain radiation therapy (HA-WBRT) in the treatment of multiple brain metastases (1). With the publication of the NRG CC001 randomised trial showing better preservation of cognitive function and patient-reported symptoms with no difference in intracranial progression or overall survival, HA-WBRT with memantine is now established as a new standard of care for treatment of multiple brain metastases (2). However, the planning aspect is significantly more labour-intensive than traditional WBRT. To streamline workflow, we evaluated MRI-atlas based auto-contouring of the hippocampus generated in Elements Treatment Planning System (TPS) compared with manual contouring by 3 radiation oncologists utilizing the RTOG 0933 Hippocampal Atlas (3) and contours done by a neuroradiologist.