Delineation of organs at risk

Area of Science:

• Radiation Oncology
• Medical Imaging
• Clinical Decision-Making

Background:

• Accurate delineation of organs at risk is fundamental in radiotherapy for target volume identification and dose optimization.
• Evolving imaging technologies and increased understanding of treatment side effects necessitate updated contouring practices.
• Extended patient survival and the rise of re-irradiation demand more systematic and precise delineation to prevent rare complications and manage complex cases.

Purpose of the Study:

• To present an updated set of recommendations for the delineation of organs at risk in radiation oncology.
• To incorporate recent findings and adaptations in contouring guidelines based on advancements in the field.
• To provide clinicians with current best practices for defining critical structures in radiotherapy planning.

Main Methods:

• Review and synthesis of current literature and clinical practices in organs at risk delineation.
• Expert consensus development based on the French Society for Radiation Oncology (SFRO) guidelines.
• Analysis of changes driven by improved imaging and evolving knowledge of treatment-related toxicities.

Main Results:

• Identification of specific contour changes required due to advancements in imaging modalities.
• Adaptation of volume definitions for organs at risk based on new knowledge of potential side effects.
• Emphasis on systematic and precise delineation to address increased patient survival and re-irradiation scenarios.

Conclusions:

• Updated recommendations are crucial for radiation oncologists to adapt to the dynamic landscape of radiotherapy.
• Precise delineation of organs at risk directly impacts patient prognosis and quality of life.
• Adherence to revised guidelines ensures optimal radiation therapy delivery, minimizing risks and maximizing benefits for patients.