title: A pragmatic contouring guideline for salivary gland structures in head and neck radiation oncology: the MOIST target.
abstract: OBJECTIVE
  One of the main normal tissue toxicities in head and neck radiation oncology is xerostomia. In several studies, reduced radiation dose to the salivary glands has been shown to diminish the effects of gland dysfunction. However, no clear guidelines exist to define the anatomic location of the involved glands on cross-sectional imaging in a pragmatic manner. This study presents an anatomic, computed tomography (CT)-based definition of the major and minor salivary glands.
  
  
  METHODS
  On the basis of information from normal structure anatomy, the location of major and minor salivary glands was identified and translated into a cross-sectional CT-based description of the salivary glands.
  
  
  RESULTS
  The major salivary glands include the parotids and submandibular glands. The minor salivary glands are presented as a part of a surrogate structure (the Minor Oral Including Sublingual Salivary Tissue target), including the minor glands located in the oral mucosa of the tongue, hard and soft palate, buccal mucosa, and inner surface of the lips.
  
  
  CONCLUSIONS
  Clinical implementation of CT-based delineations of the salivary glands according to the proposed guideline should reduce interobserver variability. This may lead to an improved understanding of the relationship between radiation dose and volume and effects on salivary function.
authors.affiliation: Radiation Medicine Program, Princess Margaret Hospital, Toronto, Ontario, Canada.
authors.forename: Frank
authors.initials: F
authors.lastname: Hoebers
authors.forename: Eugene
authors.initials: E
authors.lastname: Yu
authors.forename: Avi
authors.initials: A
authors.lastname: Eisbruch
authors.forename: Wade
authors.initials: W
authors.lastname: Thorstad
authors.forename: Brian
authors.initials: B
authors.lastname: O'Sullivan
authors.forename: Laura A
authors.initials: LA
authors.lastname: Dawson
authors.forename: Andrew
authors.initials: A
authors.lastname: Hope
mesh_terms: D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D015588:Observer Variation; D018787:Radiation Oncology / Q000379:methods*; D012469:Salivary Glands / Q000033:anatomy & histology* / Q000528:radiation effects; D012796:Sialography / Q000379:methods*; D014057:Tomography, X-Ray Computed