Evidence map›Paper›PMID 40242807›Full record

ArticlePhysics and imaging in radiation oncology2025

Development and external multicentric validation of a deep learning-based clinical target volume segmentation model for whole-breast radiotherapy.

Maria Giulia Ubeira-Gabellini, Gabriele Palazzo, Martina Mori, Alessia Tudda, Luciano Rivetti, Elisabetta Cagni, Roberta Castriconi, Valeria Landoni, Eugenia Moretti, Aldo Mazzilli and 9 more

Abstract read
In one paragraph

Article 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 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Article
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

19 authors.

Maria Giulia Ubeira-GabelliniMedical Physics, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Gabriele PalazzoMedical Physics, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Martina MoriMedical Physics, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Alessia TuddaMedical Physics, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Luciano RivettiUniversity of Ljubljana, Faculty of Mathematics and Physics, Ljubljana, Slovenia.
Elisabetta CagniMedical Physics Unit, Department of Advanced Technology, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
Roberta CastriconiMedical Physics, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Valeria LandoniIstituto Nazionale dei tumori Regina Elena, Rome, Italy.
Eugenia MorettiDepartment of Medical Physics, University Hospital, Udine, Italy.
Aldo MazzilliMedical Physics Dept, University Hospital of Parma AOUP, Italy.
Caterina OlivieroUniversity Hospital, "Federico II", Naples, Italy.
Lorenzo PlacidiFondazione Policlinico Universitario A. Gemelli IRCCS, uosd medical physics and radioprotection, Rome, Italy.
Giulia Rambaldi GuidasciUOC di Radioterapia Oncologica, Fatebenefratelli Isola Tiberina - Gemelli Isola, Rome, Italy.
Cecilia RianiMedical Physics, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Andrei FodorRadiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Nadia Gisella Di MuzioRadiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Robert JerajUniversity of Ljubljana, Faculty of Mathematics and Physics, Ljubljana, Slovenia.
Antonella Del VecchioMedical Physics, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Claudio FiorinoMedical Physics, IRCCS San Raffaele Scientific Institute, Milan, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background and purpose: In order to optimize the radiotherapy treatment and minimize toxicities, organs-at-risk (OARs) and clinical target volume (CTV) must be segmented. Deep Learning (DL) techniques show significant potential for performing this task effectively. The availability of a large single-institute data sample, combined with additional numerous multi-centric data, makes it possible to develop and validate a reliable CTV segmentation model. Materials and methods: Planning CT data of 1822 patients were available (861 from a single center for training and 961 from 8 centers for validation). A preprocessing step, aimed at standardizing all the images, followed by a 3D-Unet capable of segmenting both right and left CTVs was implemented. The metrics used to evaluate the performance were the Dice similarity coefficient (DSC), the Hausdorff distance (HD), and its 95th percentile variant (HD_95) and the Average Surface Distance (ASD). Results: The segmentation model achieved high performance on the validation set (DSC: 0.90; HD: 20.5 mm; HD_95: 10.0 mm; ASD: 2.1 mm; epoch 298). Furthermore, the model predicted smoother contours than the clinical ones along the cranial-caudal axis in both directions. When applied to internal and external data the same metrics demonstrated an overall agreement and model transferability for all but one (Inst 9) center. Conclusion: . A 3D-Unet for CTV segmentation trained on a large single institute cohort consisting of planning CTs and manual segmentations was built and externally validated, reaching high performance.

Indexed as

Artificial intelligenceBreast clinical target volumeDeep learningRadiotherapySegmentation

Identifiers

PMID40242807
PMCPMC12002654

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

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.