Advances in Radiation Oncology (Mar 2023)

Magnetic Resonance Imaging–Based Delineation of Organs at Risk in the Head and Neck Region

  • Viktor R. Paczona, MD,
  • Marta E. Capala, MD, PhD,
  • Borbála Deák-Karancsi, MD,
  • Emőke Borzási, MD,
  • Zsófia Együd, MD,
  • Zoltán Végváry, MD,
  • Gyöngyi Kelemen, MD, PhD,
  • Renáta Kószó, MD, PhD,
  • László Ruskó, PhD,
  • Lehel Ferenczi, MScEng,
  • Gerda M. Verduijn, MD,
  • Steven F. Petit, PhD,
  • Judit Oláh, MD, PhD, DSC,
  • Adrienne Cserháti, MD,
  • Florian Wiesinger, PhD,
  • Katalin Hideghéty, MD, PhD

Journal volume & issue
Vol. 8, no. 2
p. 101042

Abstract

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Purpose: The aim of this article is to establish a comprehensive contouring guideline for treatment planning using only magnetic resonance images through an up-to-date set of organs at risk (OARs), recommended organ boundaries, and relevant suggestions for the magnetic resonance imaging (MRI)–based delineation of OARs in the head and neck (H&N) region. Methods and Materials: After a detailed review of the literature, MRI data were collected from the H&N region of healthy volunteers. OARs were delineated in the axial, coronal, and sagittal planes on T2-weighted sequences. Every contour defined was revised by 4 radiation oncologists and subsequently by 2 independent senior experts (H&N radiation oncologist and radiologist). After revision, the final structures were presented to the consortium partners. Results: A definitive consensus was reached after multi-institutional review. On that basis, we provided a detailed anatomic and functional description and specific MRI characteristics of the OARs. Conclusions: In the era of precision radiation therapy, the need for well-built, straightforward contouring guidelines is on the rise. Precise, uniform, delineation-based, automated OAR segmentation on MRI may lead to increased accuracy in terms of organ boundaries and analysis of dose-dependent sequelae for an adequate definition of normal tissue complication probability.