ArticleJournal of neuro-oncology2019
NRG brain tumor specialists consensus guidelines for glioblastoma contouring.
Article in Journal of neuro-oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 64 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
64 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Timing of Planning Magnetic Resonance Imaging and Patient Selection for Adaptive Radiation Therapy in Newly Diagnosed High-Grade Glioma.International journal of radiation oncology, biology, physics · 2025Pooled it
- Modified Target Delineation and Moderately Hypofractionated Radiotherapy for High-Grade Glioma: A Randomized Clinical Trial.JAMA network open · 2025Trial
- Amide proton transfer-weighted CEST MRI for radiotherapy target delineation of glioblastoma: a prospective pilot study.European radiology experimental · 2024Trial
- Does Limited-Margin Radiotherapy Change the Recurrence Pattern and Survival of Patients With IDH-Wild-Type Glioblastoma? Analysis and Validation of a Different Approach.Asia-Pacific journal of clinical oncology · 2026Article
- Optimizing the Stupp protocol for treatment of glioblastoma: eliminating age bias, enhancing treatment timing, use of stereotactically-guided sequential boost, and dexamethasone dosing.Journal of neuro-oncology · 2026Article
- Clinical, molecular, and immunologic determinants of survival in WHO-defined IDH-wildtype glioblastoma treated with radiotherapy: a large real-world cohort study.Journal of neuro-oncology · 2026Article
- Article
- Comparative analysis of outcome, recurrence patterns, and dosimetry in glioblastoma patients treated according to RTOG versus EORTC contouring guidelines.Neuro-oncology practice · 2026Article
- Feasibility and Tumor Dynamics of Daily MRI-Guided Online Adaptive Radiotherapy for Brain Glioma.CNS neuroscience & therapeutics · 2026Observational
- Pattern of recurrence with 1.0 cm CTV in brain glioblastoma treated with radiotherapy.Journal of neuro-oncology · 2025Article
- Advances in Artificial Intelligence for Glioblastoma Radiotherapy Planning and Treatment.Cancers · 2025Review
- Glioblastoma in adults: A Society for Neuro-Oncology (SNO) and European Society of Neuro-Oncology (EANO) consensus review on current management and future directions.Neuro-oncology · 2025Review
- Clinical target volumes for glioma - Automated delineation to improve neuroanatomic consistency.Physics and imaging in radiation oncology · 2025Article
- Temporospatial tumor dynamic changes in glioblastoma during radiotherapy.Journal of neuro-oncology · 2025Article
- Segmentation of Brain Tumors Using a Multi-Modal Segment Anything Model (MSAM) with Missing Modality Adaptation.Bioengineering (Basel, Switzerland) · 2025Article
- Advancements in adaptive MR-guided radiotherapy for high-grade gliomas.Journal of neuro-oncology · 2025Article
- Comparative Outcomes of Standard Radiation Therapy and 5-Fraction Adaptive Stereotactic Radiation Therapy in Newly Diagnosed Glioblastoma: A Propensity Score-Matched Analysis.Advances in radiation oncology · 2025Article
- Defining occult disease in glioblastoma using spectroscopic MRI: implications for clinical target volume delineation.Radiation oncology (London, England) · 2025Article
- Magnetic resonance imaging in glioblastoma radiotherapy - beyond treatment adaptation.Physics and imaging in radiation oncology · 2025Article
- Precision radiotherapy with molecular-profiling of CNS tumours.Journal of neuro-oncology · 2025Review
4 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
introductionNRG protocols for glioblastoma allow for clinical target volume (CTV) reductions at natural barriers; however, literature examining CTV contouring and the relevant white matter pathways is lacking. This study proposes consensus CTV guidelines, with a focus on areas of controversy while highlighting common errors in glioblastoma target delineation.
methodsTen academic radiation oncologists specializing in brain tumor treatment contoured CTVs on four glioblastoma cases. CTV expansions were based on NRG trial guidelines. Contour consensus was assessed and summarized by kappa statistics. A meeting was held to discuss the mathematically averaged contours and form consensus contours and recommendations.
resultsContours of the cavity plus enhancement (mean kappa 0.69) and T2-FLAIR signal (mean kappa 0.74) showed moderate to substantial agreement. Experts were asked to trim off anatomic barriers while respecting pathways of spread to develop their CTVs. Submitted CTV_4600 (mean kappa 0.80) and CTV_6000 (mean kappa 0.81) contours showed substantial to near perfect agreement. Simultaneous truth and performance level estimation (STAPLE) contours were then reviewed and modified by group consensus. Anatomic trimming reduced the amount of total brain tissue planned for radiation targeting by a 13.6% (range 8.7-17.9%) mean proportional reduction. Areas for close scrutiny of target delineation were described, with accompanying recommendations.
conclusionsConsensus contouring guidelines were established based on expert contours. Careful delineation of anatomic pathways and barriers to spread can spare radiation to uninvolved tissue without compromising target coverage. Further study is necessary to accurately define optimal target volumes beyond isometric expansion techniques for individual patients.
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