Original ArticleDelineation of whole heart and substructures in thoracic radiation therapy: National guidelines and contouring atlas by the Danish Multidisciplinary Cancer Groups
Section snippets
Guideline and cardiac contouring
One oncologist (MLHM) performed contouring of the heart and cardiac substructures on randomly selected non-contrast enhanced, planning CT scans of ten breast cancer patients. Based on existing cardiac contouring guidelines, preliminary guidelines detailing the delineation of the heart and 24 cardiac substructures were developed: the four cardiac chambers, the four segments of the left ventricle wall, ten coronary artery segments and six help-structures (aorta, inferior and superior vena cava,
Results
Based on existing cardiac contouring guidelines, the preliminary guidelines and preliminary atlas, final consensus regarding the guidelines of the heart and cardiac substructures was reached [16], [17]. The anatomical borders were defined from an axial CT scan. For atlas contouring, see Fig B.1.
The base of the heart emerges caudally to the right and the left main pulmonary artery, just after the split from the pulmonary trunk [16]. Caudally, the heart blends with the diaphragm. The coronary
Discussion
The majority of patients with thoracic cancer receive adjuvant or curative RT and, in Denmark, contouring of the heart is clinical practice. However, no consensus guidelines for cardiac delineation across different diagnoses were available. In this study, we present national guidelines for delineation of the whole heart and cardiac substructures for RT planning, obtained by the four DMCGs. These guidelines were intended for ensuring a standardized way to report RT dose to cardiac substructures
Disclosure of interest
The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.
Acknowledgements
The workshop was funded by the DCCC Radiotherapy – The Danish National Research Center.
BVO was supported by the Danish Cancer Society and the DCCC Radiotherapy – The Danish National Research Center.
MLHM was supported by the Danish Cancer Society, the DCCC Radiotherapy – The Danish National Research Center and Aarhus University.
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