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Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies

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Real world AI-driven segmentation: Efficiency gains and workflow challenges in radiotherapy.

Ciaran Malone¹, Jill Nicholson², Samantha Ryan¹

¹St.Luke's Radiation Oncology Network, Dublin, Ireland.

Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology

|June 5, 2025

Summary

AI-driven contouring (AIseg) significantly reduces organ-at-risk (OAR) contouring time, improving workflow efficiency. However, this task-level improvement did not shorten overall CT-to-treatment times, highlighting the need for workflow optimization.

Keywords:

AI-Segmentation Radiation Oncology Real-world impact Timing Workflow

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Area of Science:

Radiotherapy oncology
Medical physics
Health informatics

Background:

The impact of AI-driven contouring (AIseg) on radiotherapy workflow efficiency remains unclear.
Evaluating AIseg's effect on organ-at-risk (OAR) contouring time and overall treatment planning duration is crucial.

Purpose of the Study:

To assess how AIseg influences OAR contouring task duration.
To evaluate changes in the overall radiotherapy planning carepath from CT scan to treatment initiation.

Main Methods:

Retrospective analysis of OAR contouring times (pre- and post-AIseg implementation) in a large patient cohort.
Evaluation of "in-progress" and "workflow" contouring times across multiple anatomical sites.
Analysis of monthly trends and overall CT-to-treatment intervals.

Main Results:

AIseg reduced median active OAR contouring times by 51.5% (p < 0.001), with up to 70% reduction in complex cases.
Contouring workflow times showed a downward trend post-AIseg implementation (p < 0.001).
No significant decrease in overall CT-to-treatment intervals was observed, but a higher proportion of plans were ready earlier.

Conclusions:

AIseg significantly enhances contouring efficiency, especially for complex cases, and improves workflow times.
Task-level efficiency gains from AIseg do not automatically translate to shorter overall treatment pathways.
Optimizing workflow and scheduling is essential to realize meaningful improvements in patient treatment timelines.