Update of the EPTN atlas for CT- and MR-based contouring in Neuro-Oncology

Daniëlle B.P. Eekers*, Dario Di Perri, Erik Roelofs, Alida Postma, Jeanette Dijkstra, Thankamma Ajithkumar, Claire Alapetite, Malin Blomstrand, Neil G. Burnet, Valentin Calugaru, Inge Compter, Ida E.M. Coremans, Semi Harrabi, Alberto Iannalfi, Yvonne L.B. Klaver, Maarten Lambrecht, Alejandra Méndez Romero, Frank Paulsen, Beate Timmermann, Pavel VitekHiske L. van der Weide, Gillian A. Whitfield, Petra Witt Nyström, Jaap Zindler, Dirk de Ruysscher, Johannes Langendijk, Damien C. Weber, Esther G.C. Troost

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

8 Citations (Scopus)


Background and purpose: To update the digital online atlas for organs at risk (OARs) delineation in neuro-oncology based on high-quality computed tomography (CT) and magnetic resonance (MR) imaging with new OARs. Materials and methods: In this planned update of the neurological contouring atlas published in 2018, ten new clinically relevant OARs were included, after thorough discussion between experienced neuro-radiation oncologists (RTOs) representing 30 European radiotherapy-oncology institutes. Inclusion was based on daily practice and research requirements. Consensus was reached for the delineation after critical review. Contouring was performed on registered CT with intravenous (IV) contrast (soft tissue & bone window setting) and 3 Tesla (T) MRI (T1 with gadolinium & T2 FLAIR) images of one patient (1 mm slices). For illustration purposes, delineation on a 7 T MRI without IV contrast from a healthy volunteer was added. OARs were delineated by three experienced RTOs and a neuroradiologist based on the relevant literature. Results: The presented update of the neurological contouring atlas was reviewed and approved by 28 experts in the field. The atlas is available online and includes in total 25 OARs relevant to neuro-oncology, contoured on CT and MRI T1 and FLAIR (3 T & 7 T). Three-dimensional (3D) rendered films are also available online. Conclusion: In order to further decrease inter- and intra-observer OAR delineation variability in the field of neuro-oncology, we propose the use of this contouring atlas in photon and particle therapy, in clinical practice and in the research setting. The updated atlas is freely available on www.cancerdata.org.

Original languageEnglish
Pages (from-to)259-265
Number of pages7
JournalRadiotherapy and Oncology
Publication statusPublished - 1 Jul 2021


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