This effort was largely initiated for the purpose of education in a relatively novel site for radiation therapy, the liver, where there are many contouring challenges including mobile, deformable organs, “variant” anatomy, complex vasculature, and a requirement to understand the terminology used among other oncologic specialties (ie, liver segment definitions). Goals of the panel were to develop uniform definitions for upper abdominal normal tissue anatomy, to propose standards for contouring these organs, and to create an image-rich upper abdominal organ atlas. To establish consistency in contouring upper abdominal normal tissues, and in preparation for the Radiation Therapy Oncology Group (RTOG) 1112 trial, a randomized phase 3 study of sorafenib versus SBRT followed by sorafenib in hepatocellular carcinoma, the RTOG organized a consensus panel. Only recently, normal tissue contouring atlases for radiation planning (eg, lung, pelvis, postoperative pancreas) have been published. There has been little standardization to facilitate consistent and accurate normal organ contouring. It is critical to accurately identify and contour the normal organ anatomy on computed tomography (CT)-based planning images to maintain appropriate radiation doses and minimize toxicity in critical normal tissues, for dose and volume reporting, and for investigations of dose–volume toxicity relationships. 1 One of the main purposes of IMRT and SBRT is to reduce the dose to surrounding normal tissues. High precision radiation therapy, including intensity modulated radiation therapy (IMRT) and stereotactic body radiotherapy (SBRT), has increased in usage over the past decade, including in the upper abdomen.
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