Contouring guidelines¶
The following contouring guidelines were provided to the experts drawing the ground truth contours. Consequently, they should form the basis of any system preforming auto-contouring. Please note however, the expert contours, have not be checked by the organisers as conforming to these guidelines - since variation in expert opinion is one of the challenges for clinical systems. To mitigate this variation to some extent, a consensus contour of the expert contours will be used as the reference contour against which plans and contours will be assessed.
Naming convention¶
The naming will follow TG-263 [1]. The tables below define the structure names to be used. An attempt will be made to allow for some variation in naming following the dictionary-based approach of Schuler et al. [2], but adhering to the convention will ensure successful interpretation.
Structure | Notes |
Bowel_Bag | Participants may add "~" if not whole structure |
Bladder | |
Rectum | |
Femur_Head_L | |
Femur_Head_R | |
Prostate | The anatomical prostate used to derive treatment volumes |
SeminalVes | The full seminal vesicles |
Proximal_SeminalVes | Assume all patients are intermediate risk according to Salembier et al. [5] |
CTV_Prostate | Prostate |
CTV_SeminalVes | |
CTV_LN_Pelvic | |
CTV_ProstateBed | |
PTVp_7400 | Prostate. Assume no SV involvement |
PTVp_7100 | Prostate. Assume no SV involvement |
PTVp_6000 | Prostate + Proximal SV. Equivalent to PTVpsv_6000 in supplementary material to Dearnaley et al. [3] |
PTVp_6600 | Prostate Bed PTV |
PTVn_6000 | Nodal planning volume for Prostate + Nodes cases, consisting of PTVn + PTVp_6000 |
PTVn_5000 | Nodal planning volume for ProstateBed + Nodes cases, consisting of PTVn + PTVp_6600 |
Organ-at-risk definitions¶
OARs are to be contoured according to Gay et al. [4]
CTV contour definitions¶
Prostate and Seminal Vesicles should be contoured according to Salembier
et al. [5]
ProstateBed should be contoured according to Robin et al.
[6]
Pelvic Lymph Nodes should be contoured according to Harris et al.
[7]
PTV contour definitions¶
PTV definitions for Prostate and Prostate+Nodes will follow the PIVOTAL trial. The following is adapted from the supplementary material to Dearnaley et al. [3], noting that the CTV_SeminalVes definition follows [5]. For the prostate bed a PTV margin of 5mm will be used following Poortmans et al. [8] The table below details the PTV regions.
Tumour and Clinical Target Volumes | Clinical Target Volume | Planning Target Volumes |
Prostate and seminal vesicles | CTV_Prostate + CTV_SeminalVes Outline: prostate & seminal vesicles |
PTVp_6000 10mm isotropic margin from CTV |
Prostate (+ any involved seminal vesicle) | CTV_Prostate Outline: prostate and any involved seminal vesicle |
PTVp_7100 10mm margin in all directions except 5mm towards Rectum from CTV |
CTV_Prostate Outline: prostate and any involved seminal vesicle |
PTVp_7400 5mm margin in all directions except 0mm towards Rectum from CTV |
|
Prostate Bed PTV | CTV_ProstateBed Outline: prostate bed |
PTVp_6600 Margin 5mm in all directions from CTV |
Pelvic lymph nodes | CTV_LN_Pelvic Outline: pelvic lymph nodes |
PTVn 5mm margin in all directions from CTV |
For Prostate + Nodes cases | PTVn_6000 = PTVp_6000 + PTVn | |
For ProstateBed cases | PTVn_4600 = PTVp_6600 + PTVn |
Full guidelines¶
Full guidelines including appendix are available to download in pdf format
References¶
- Mayo CS, Moran JM, Bosch W, et al. American Association of Physicists in Medicine Task Group 263: Standardizing Nomenclatures in Radiation Oncology. Int J Radiat Oncol Biol Phys 2018; 100: 1057–66.
- Schuler T, Kipritidis J, Eade T, et al. Big Data Readiness in Radiation Oncology: An Efficient Approach for Relabeling Radiation Therapy Structures With Their TG-263 Standard Name in Real-World Data Sets. Adv Radiat Oncol 2019; 4: 191–200.
- Dearnaley D, Griffin CL, Lewis R, et al. Toxicity and Patient-Reported Outcomes of a Phase 2 Randomized Trial of Prostate and Pelvic Lymph Node Versus Prostate only Radiotherapy in Advanced Localised Prostate Cancer (PIVOTAL). Int J Radiat Oncol Biol Phys 2019; 103: 605–17.
- Gay HA, Barthold HJ, O’Meara E, et al. Pelvic Normal Tissue Contouring Guidelines for Radiation Therapy: A Radiation Therapy Oncology Group Consensus Panel Atlas. Int J Radiat Oncol 2012; 83: e353–62.
- Salembier C, Villeirs G, De Bari B, et al. ESTRO ACROP consensus guideline on CT- and MRI-based target volume delineation for primary radiation therapy of localized prostate cancer. Radiother Oncol 2018; 127: 49–61.
- Robin S, Jolicoeur M, Palumbo S, et al. Prostate Bed Delineation Guidelines for Postoperative Radiation Therapy: On Behalf Of The Francophone Group of Urological Radiation Therapy. Int J Radiat Oncol Biol Phys 2021; 109: 1243–53.
- Harris VA, Staffurth J, Naismith O, et al. Consensus guidelines and contouring atlas for pelvic node delineation in prostate and pelvic node intensity modulated radiation therapy. Int J Radiat Oncol Biol Phys 2015; 92: 874–83.
- Poortmans P, Bossi A, Vandeputte K, et al. Guidelines for target volume definition in post-operative radiotherapy for prostate cancer, on behalf of the EORTC Radiation Oncology Group. Radiother Oncol 2007; 84: 121–7.
- Hall WA, Paulson E, Davis BJ, et al. NRG Oncology Updated International Consensus Atlas on Pelvic Lymph Node Volumes for Intact and Postoperative Prostate Cancer. Int J Radiat Oncol 2021; 109: 174–85.
- McLaughlin PW, Evans C, Feng M, Narayana V. Radiographic and Anatomic Basis for Prostate Contouring Errors and Methods to Improve Prostate Contouring Accuracy. Int J Radiat Oncol 2010; 76: 369–78.