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Updated: Jun 27, 2026

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Foundation Model-Driven Regions of Interest Classification and Renaming in Cancer Radiotherapy: A Customizable,

Dong Yang1,2, Mingjun Lei3, Qiangxing Yang4

  • 1Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.

JCO Clinical Cancer Informatics
|June 25, 2026
PubMed
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This study developed an automated workflow using AI to standardize cancer radiotherapy region naming, improving accuracy and interoperability across institutions. The system achieved high accuracy in classifying and renaming regions, enhancing clinical workflows.

Area of Science:

  • Medical Physics
  • Artificial Intelligence in Healthcare
  • Radiotherapy Oncology

Background:

  • Inconsistent naming of regions of interest (ROIs) in radiotherapy planning hinders interoperability and automation.
  • Standardization is crucial for reproducible and efficient cancer treatment workflows.

Purpose of the Study:

  • To develop and evaluate a foundation model-based workflow for automated ROI classification and standardization.
  • To align ROI nomenclature with AAPM Task Group 263 (TG-263) standards while allowing institutional customization.

Main Methods:

  • A four-stage pipeline integrating large language models (LLMs) and a Contrastive Language-Image Pretraining (CLIP) model was created.
  • The workflow performs anatomic site classification, ROI type classification, standardization, and laterality verification.

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  • Evaluated on 600 patients across three institutions and five disease sites using DICOM RTSTRUCT and CT data.
  • Main Results:

    • Achieved 99.12% accuracy for ROI type classification and 97.92% for renaming.
    • High performance was consistent across institutions and disease sites.
    • CLIP-based laterality verification successfully corrected all errors in targeted testing.

    Conclusions:

    • Foundation language models and vision-language modules can automate ROI classification and naming in radiotherapy.
    • The proposed workflow is retraining-free, customizable, and robust for standardizing cancer radiotherapy.
    • This approach enhances clinical workflow efficiency and reduces ambiguity in radiotherapy planning.