Radiation Oncology
What’s in a Name? While a rose by any other name would smell as sweet, if we all agree to call cow manure a rose, that would not make it smell any better. In order to communicate clearly about radiation treatments for patients we need to agree on exact definitions and words. There is significant diversity in how we assign names to target structures, organat-risk (OARs), and other treatment planning parameters like dosevolume histogram (DVH) terms. These inconsistencies exist within individuals’ practice, within our departments and almost certainly between departments. In Australia and New Zealand, we can take advantage of the best of international expertise and experience and adapt it to our practice. In 2014, the American Association of Physicists in Medicine (AAPM) assigned a
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multidisciplinary group the considerable task of standardising structure names, nomenclature for dosimetric data and templates for clinical trial groups. The resulting report, published in 2018 (1) aims to point us in the right direction. Standardisation has many advantages. Standardising how we name our planning terms can result in improved workflow, more efficient peer review and facilitate research when it comes to transferring treatment-related data between institutions. In the short term, some proposed benefits are a faster, more systematic plan review process. With a standardised approach, scripting also becomes easier and we will be able to take advantage of automated processes in treatment planning systems.
Treatment protocols can be followed more closely and standardised naming will facilitate clinical improvement projects. In the longer term, a universal standardised approach in nomenclature can help with the emerging fields of Big Data and Machine Learning in radiation oncology. (2,3) The report benefited from a diverse group of stakeholders including endusers of treatment planning software as well as vendors. The AAPM Task Group 263 thoroughly evaluated current practices across the US and distilled the most common practices and then made recommendations regarding the nomenclature of target volumes, nontarget volumes and DVH metrics.
