<abstract xmlns="http://www.w3.org/1999/xhtml"><sec><h3>Background</h3><p>Modern radiotherapy techniques enable delivery of high doses to the target volume without escalating dose to organs at risk, offering the possibility of better local control while preserving good quality of life. Uncertainties in target volume delineation have been demonstrated for most tumour sites, and various studies indicate that inconsistencies in target volume delineation may be larger than errors in all other steps of the treatment planning and delivery process. The aim of this paper is to summarize the degree of delineation uncertainties for different tumour sites reported in the literature and review the effect of strategies to minimize them.</p></sec><sec><h3>Conclusions</h3><p>Our review confirmed that interobserver variability in target volume contouring represents the largest uncertainty in the process for most tumour sites, potentially resulting in a systematic error in dose delivery, which could influence local control in individual patients. For most tumour sites the optimal combination of imaging modalities for target delineation still needs to be determined. Strict use of delineation guidelines and protocols is advisable both in every day clinical practice and in clinical studies to diminish interobserver variability. Continuing medical education of radiation oncologists cannot be overemphasized, intensive formal training on interpretation of sectional imaging should be included in the program for radiation oncology residents.</p></sec></abstract>

BackgroundModern radiotherapy techniques enable delivery of high doses to the target volume without escalating dose to organs at risk, offering the possibility of better local control while preserving good quality of life. Uncertainties in target volume delineation have been demonstrated for most tumour sites, and various studies indicate that inconsistencies in target volume delineation may be larger than errors in all other steps of the treatment planning and delivery process. The aim of this paper is to summarize the degree of delineation uncertainties for different tumour sites reported in the literature and review the effect of strategies to minimize them.ConclusionsOur review confirmed that interobserver variability in target volume contouring represents the largest uncertainty in the process for most tumour sites, potentially resulting in a systematic error in dose delivery, which could influence local control in individual patients. For most tumour sites the optimal combination of imaging modalities for target delineation still needs to be determined. Strict use of delineation guidelines and protocols is advisable both in every day clinical practice and in clinical studies to diminish interobserver variability. Continuing medical education of radiation oncologists cannot be overemphasized, intensive formal training on interpretation of sectional imaging should be included in the program for radiation oncology residents.

Uncertainties in target volume delineation in radiotherapy – are they relevant and what can we do about them?

Department of Radiation Oncology, Institute of Oncology Ljubljana, Slovenia

Department of Radation Oncology, National Centre for Cancer Care and Research, Doha, Qatar

Radiology and Oncology

BackgroundModern radiotherapy techniques enable delivery of high doses to the target volume without escalating dose to organs at risk, offering the possibility...

Uncertainties in target volume delineation in radiotherapy – are they relevant and what can we do about them?

Article Category: Research Article

Published Online: May 09, 2016

Page range: 254 - 262

Received: Dec 29, 2015

Accepted: Feb 01, 2016

DOI: https://doi.org/10.1515/raon-2016-0023

Keywords
target volume, interobserver variability, delineation uncertainties, imaging, training

© 2016 Radiol Oncol

This content is free.

Uncertainties in target volume delineation in radiotherapy – are they relevant and what can we do about them?

Article Category: Research Article

Published Online: May 09, 2016

Page range: 254 - 262

Received: Dec 29, 2015

Accepted: Feb 01, 2016

DOI: https://doi.org/10.1515/raon-2016-0023

Keywordstarget volume, interobserver variability, delineation uncertainties, imaging, training

© 2016 Radiol Oncol

This content is free.

Keywords
target volume, interobserver variability, delineation uncertainties, imaging, training