Organs at risk in the brain and their dose-constraints in adults and in children: a radiation oncologist's guide for delineation in everyday practice

Radiother Oncol. 2015 Feb;114(2):230-8. doi: 10.1016/j.radonc.2015.01.016. Epub 2015 Feb 17.


Purpose: Accurate organs at risk definition is essential for radiation treatment of brain tumors. The aim of this study is to provide a stepwise and simplified contouring guide to delineate the OARs in the brain as it would be done in the everyday practice of planning radiotherapy for brain cancer treatment.

Methods: Anatomical descriptions and neuroimaging atlases of the brain were studied. The dosimetric constraints used in literature were reviewed.

Results: A Computed Tomography and Magnetic Resonance Imaging based detailed atlas was developed jointly by radiation oncologists, a neuroradiologist and a neurosurgeon. For each organ brief anatomical notion, main radiological reference points and useful considerations are provided. Recommended dose-constraints both for adult and pediatric patients were also provided.

Conclusions: This report provides guidelines for OARs delineation and their dose-constraints for the treatment planning of patients with brain tumors.

Keywords: Brain contouring atlas; Dose-constraints; Normal tissue; Optic chiasm; Organs at risk; Radiotherapy atlas.

MeSH terms

  • Adult
  • Brain / anatomy & histology*
  • Brain / radiation effects*
  • Brain Neoplasms / radiotherapy*
  • Child
  • Cochlea / anatomy & histology
  • Cochlea / radiation effects
  • Female
  • Humans
  • Magnetic Resonance Imaging / methods
  • Male
  • Neuroimaging / methods
  • Optic Chiasm / anatomy & histology
  • Optic Chiasm / radiation effects
  • Organs at Risk / radiation effects*
  • Pituitary Gland / anatomy & histology
  • Pituitary Gland / radiation effects
  • Radiation Dosage
  • Radiometry / methods
  • Radiotherapy Planning, Computer-Assisted / methods*
  • Tomography, X-Ray Computed / methods