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Delineating brachial plexus, cochlea, pharyngeal constrictor muscles and optic chiasm in head and neck radiotherapy: a CT-based model atlas

  • DIAGNOSTIC IMAGING IN ONCOLOGY
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Abstract

Background and purpose

Sparing of the organs at risk is one of the primary end-points of radiotherapy. The effects of organ-at-risk delineation on the dosimetric parameters can be critical and can influence treatment planning and outcomes. The aim of our study was to provide anatomical boundaries for the identification and delineation of the following critical organs at risk in the head and neck district: brachial plexus, cochlea, pharyngeal constrictor muscles and optic chiasm.

Patients and methods

One patient was initially selected to elaborate our atlas. This patient was subjected to a planning computed tomography of the brain and head and neck district; axial images of 3-mm thickness at 3-mm intervals were obtained. In the same set-up a magnetic resonance imaging study was also performed. The obtained images were fused based on anatomical landmarks and used by a radiation oncologist, supported by a neuroradiologist, to provide anatomo-radiological limits for the identification of the brachial plexus, cochlea, pharyngeal constrictor muscles and optic chiasm. These limits were further verified on three consecutive patients.

Results

A computed tomography-based atlas was developed with definition of cranial, caudal, medial, lateral, anterior and posterior limits for each organ considered.

Conclusions

This study allows improvement of definitions of anatomic boundaries for the brachial plexus, cochlea, pharyngeal constrictor muscles and optic chiasm. Our multidisciplinary experience led to the production of an institutional reference tool that could represent a useful aid for radiation oncologists in clinical practice.

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Conflict of interest

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Department of Radiation Oncology, “G. D’Annunzio” University of Chieti, SS. Annunziata Hospital, Chieti, Italy

    Domenico Genovesi, Francesca Perrotti, Marianna Trignani, Angelo Di Pilla, Annamaria Vinciguerra, Antonietta Augurio, Monica Di Tommaso & Giampiero Ausili Cèfaro

  2. Department of Neuroscience and Imaging, “G. D’Annunzio” University of Chieti, Chieti, Italy

    Massimo Caulo & Armando Tartaro

  3. Department of Radiology, “G. D’Annunzio” University of Chieti, SS. Annunziata Hospital, Chieti, Italy

    Massimo Savastano & Antonio Raffaele Cotroneo

  4. Istituto di Radioterapia Ospedale Clinicizzato “SS. Annunziata”, via dei Vestini, 66100, Chieti, Italy

    Domenico Genovesi

Authors
  1. Domenico Genovesi
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  2. Francesca Perrotti
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  3. Marianna Trignani
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  4. Angelo Di Pilla
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  5. Annamaria Vinciguerra
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  12. Giampiero Ausili Cèfaro
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Correspondence to Domenico Genovesi.

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Genovesi, D., Perrotti, F., Trignani, M. et al. Delineating brachial plexus, cochlea, pharyngeal constrictor muscles and optic chiasm in head and neck radiotherapy: a CT-based model atlas. Radiol med 120, 352–360 (2015). https://doi.org/10.1007/s11547-014-0448-2

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  • DOI: https://doi.org/10.1007/s11547-014-0448-2

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