Improving the identification of male pelvic structures in post-prostatectomy patients on cone-beam CT: a region of interest atlas study

Abstract

AbstractPurpose: To investigate the benefits of a regions of interest atlas for radiation therapists (RTTs) to aid in the identification of male pelvic structures in radiotherapy for prostate cancer, post-prostatectomy.Methods and materials: Recruiting 35 radiation therapists from the Royal North Shore Hospital, a pretest- post-test study design was employed, with the atlas as the intervention. Using two patient CT data-sets, structure identification was scored as correct or incorrect and RT confidence levels were recorded using a visual analogue scale. The number of years of experience of each RT was also documented. Statistical significance was calculated using the Wilcoxon signed ranks test, paired samples t-test and chi-square tests.Results: A statistically significant improvement was found between the pre-test and post-test in terms of both structure identification (p < 0.001) and confidence (p < 0.001) levels, with use of the atlas. The atlas was of use to staff of varying experience levels. Structures that were not normally used for target volume localisation were the hardest to identify.Conclusion: Regions of interest atlases should be implemented to help identification of areas of anatomical complexity.