title: 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.
abstract: OBJECTIVE
  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.
authors.affiliation: Radiation Oncology, Azienda Universitaria Ospedaliera Careggi, Florence, Italy. Electronic address: silvia.scoccianti@unifi.it.
authors.forename: Silvia
authors.initials: S
authors.lastname: Scoccianti
authors.affiliation: Radiation Oncology, Azienda Universitaria Ospedaliera Careggi, Florence, Italy.
authors.forename: Beatrice
authors.initials: B
authors.lastname: Detti
authors.affiliation: Neuroradiology Unit, Azienda Universitaria Ospedaliera Careggi, Florence, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Gadda
authors.affiliation: Radiation Oncology, Azienda Universitaria Ospedaliera Careggi, Florence, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Greto
authors.affiliation: Radiation Oncology, Azienda Universitaria Ospedaliera Careggi, Florence, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Furfaro
authors.affiliation: Radiation Oncology, Azienda Universitaria Ospedaliera Careggi, Florence, Italy.
authors.forename: Fiammetta
authors.initials: F
authors.lastname: Meacci
authors.affiliation: Radiation Oncology, Azienda Universitaria Ospedaliera Careggi, Florence, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Simontacchi
authors.affiliation: Radiation Oncology, Azienda Universitaria Ospedaliera Careggi, Florence, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Di Brina
authors.affiliation: Radiation Oncology, Azienda Universitaria Ospedaliera Careggi, Florence, Italy.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Bonomo
authors.affiliation: Radiation Oncology, Azienda Universitaria Ospedaliera Careggi, Florence, Italy.
authors.forename: Irene
authors.initials: I
authors.lastname: Giacomelli
authors.affiliation: Radiation Oncology, Azienda Universitaria Ospedaliera Careggi, Florence, Italy.
authors.forename: Icro
authors.initials: I
authors.lastname: Meattini
authors.affiliation: Radiation Oncology, Azienda Universitaria Ospedaliera Careggi, Florence, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Mangoni
authors.affiliation: Radiation Oncology, Azienda Universitaria Ospedaliera Careggi, Florence, Italy.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Cappelli
authors.affiliation: Radiation Oncology, Azienda Universitaria Ospedaliera Careggi, Florence, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Cassani
authors.affiliation: Medical Physics, Azienda Universitaria Ospedaliera Careggi, Florence, Italy.
authors.forename: Cinzia
authors.initials: C
authors.lastname: Talamonti
authors.affiliation: Neurosurgery, Azienda Universitaria Ospedaliera Careggi, Florence, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Bordi
authors.affiliation: Radiation Oncology, Azienda Universitaria Ospedaliera Careggi, Florence, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Livi
mesh_terms: D000328:Adult; D001921:Brain / Q000033:anatomy & histology* / Q000528:radiation effects*; D001932:Brain Neoplasms / Q000532:radiotherapy*; D002648:Child; D003051:Cochlea / Q000033:anatomy & histology / Q000528:radiation effects; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D059906:Neuroimaging / Q000379:methods; D009897:Optic Chiasm / Q000033:anatomy & histology / Q000528:radiation effects; D058958:Organs at Risk / Q000528:radiation effects*; D010902:Pituitary Gland / Q000033:anatomy & histology / Q000528:radiation effects; D011829:Radiation Dosage; D011874:Radiometry / Q000379:methods; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods
keywords: Brain contouring atlas; Dose-constraints; Normal tissue; Optic chiasm; Organs at risk; Radiotherapy atlas