Evidence map›Paper›PMID 40026912›Full record

ReviewPhysics and imaging in radiation oncology2025

A systematic review of the role of artificial intelligence in automating computed tomography-based adaptive radiotherapy for head and neck cancer.

Edoardo Mastella, Francesca Calderoni, Luigi Manco, Martina Ferioli, Serena Medoro, Alessandro Turra, Melchiore Giganti, Antonio Stefanelli

Abstract readReview
In one paragraph

Review in Physics and imaging in radiation oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed.

  1. Article
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  8. Systematic review of artificial intelligence in brachytherapy.Journal of contemporary brachytherapy · 2026
    Review
  9. Review
  10. Review
  11. Review
  12. Article
  13. Maintaining quality of scientific peer-review and publishing inPhysics and imaging in radiation oncology · 2026
    Article
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  15. Article
  16. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Edoardo MastellaMedical Physics Unit, University Hospital of Ferrara I-44124 Cona, Ferrara, Italy.
Francesca CalderoniMedical Physics Unit, University Hospital of Ferrara I-44124 Cona, Ferrara, Italy.
Luigi MancoMedical Physics Unit, University Hospital of Ferrara I-44124 Cona, Ferrara, Italy.
Martina FerioliRadiation Oncology Unit, University Hospital of Ferrara I-44124 Cona, Ferrara, Italy.
Serena MedoroRadiation Oncology Unit, University Hospital of Ferrara I-44124 Cona, Ferrara, Italy.
Alessandro TurraMedical Physics Unit, University Hospital of Ferrara I-44124 Cona, Ferrara, Italy.
Melchiore GigantiUniversity Radiology Unit, University of Ferrara I-44121 Ferrara, Italy.
Antonio StefanelliRadiation Oncology Unit, University Hospital of Ferrara I-44124 Cona, Ferrara, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose: Adaptive radiotherapy (ART) may improve treatment quality by monitoring variations in patient anatomy and incorporating them into the treatment plan. This systematic review investigated the role of artificial intelligence (AI) in computed tomography (CT)-based ART for head and neck (H&N) cancer. Methods: A comprehensive search of main electronic databases was conducted until April 2024. Titles and abstracts were reviewed to evaluate the compliance with inclusion criteria: CT-based imaging for photon ART of H&N patients and AI applications. 17 original retrospective studies with samples sizes ranging from 37 to 239 patients were included. The quality of the studies was evaluated with the Quality Assessment of Diagnostic Accuracy Studies-2 and the Checklist for Artificial Intelligence in Medical Imaging (CLAIM) tools. Key metrics were examined to evaluate the performances of the proposed AI-methods. Results: Overall, the risk of bias was low. The average CLAIM score was 70%. A major finding was that generated synthetic CTs improved similarity metrics with planning CT compared to original cone-beam CTs, with average mean absolute error up to 39 HU and maximum improvement of 80%. Auto-segmentation provided an efficient and accurate option for organ-at-risk delineation, with average Dice similarity coefficient ranging from 80 to 87%. Finally, AI models could be trained using clinical and radiomic features to predict the effectiveness of ART with accuracy above 80%. Conclusions: Automation of processes in ART for H&N cancer is very promising throughout the entire chain, from the generation of synthetic CTs and auto-segmentation to predict the effectiveness of ART.

Indexed as

Automated contouringCBCTDeep learningImage qualityMachine learningPredictive model

Identifiers

PMID40026912
PMCPMC11871500

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.