Faster and uniform
Dr. Geert Janssens is a radiotherapist at the Princess Máxima Center. He tells: 'Since a few years, the target volumes for flank radiotherapy have been revised. Radiotherapists must therefore contour all the necessary structures on the CT scan, such as every organ potentially exposed to irradiation, and of course the spot where the tumor was including the margins for movement by breathing. This is time-consuming and quickly takes four to six hours to complete. In addition, international research also shows that despite a guideline, radiotherapists sometimes contour the radiation area differently.'Therefore, as a first step, Janssens plans to work with pediatric oncologists and European colleagues in SIOP-Renal Tumor Study Group (RTSG) context to investigate whether AI can help contour organs faster and in the same way. Next, AI will be used to focus on tumor contouring. In this way, he hopes that in the future, all children with kidney tumors, regardless of where they are treated, can be treated consistently according to the same guideline. As part of this first step, Janssens organized a workshop with Dr. Matteo Maspero, assistant professor of computer imaging and clinical physicist in training at UMC Utrecht, and Prof. Marry van den Heuvel-Eibrink, research group leader and pediatric oncologist at Máxima, on Nov. 7 and 8.
'By giving flank radiation to children with kidney tumors in the same way in every country, we hope to increase the chances of a cure with a better quality of life for all these children. In addition, we increase the possibilities for further research, because this larger group of children will be treated in the same way,' adds Van den Heuvel-Eibrink.
Contouring engraftment
During the workshop, the twelve radiotherapists present, all members of the SIOP-RTSG panel, were introduced to the software that allows organs to be rapidly contoured in children. Mianyong Ding, a PhD student in the Van den Heuvel-Eibrink group and Butterfly student, is using these contoured scans to find out how much faster and more accurate deep learning-based contouring works compared to manual contouring of surrounding organs.Ding says: 'It was good to train the participants in using this program live. For example, we asked them to contour a list of seven organs as quickly and accurately as possible. In addition, the participants were asked to check as quickly and accurately as possible a list of organs contoured by the computer and adjust where necessary.'
The first version of this AI tool is expected to be validated internationally within the centers associated with SIOP-RTSG in a few months.
SIOP-Renal Tumor Study Group
To gain new scientific insights based on reliable data, international cooperation is crucial, because childhood cancer is rare. Within the SIOP-RTSG, specialists of kidney tumors in children come together. Through exchange of knowledge and joint design of studies, they hope to increase the chance of cure with optimal quality of life for these children.International Society of Pediatric Oncology (SIOP)
Van den Heuvel-Eibrink has been president of SIOP-RTSG Association since 2022 and founder and co-chair of the alliance (HARMONICA) with the Children's Oncology Renal Tumor Group. She will also chair the scientific committee of the SIOP umbrella organization from 2025, worldwide. Janssens is vice-chair of the SIOP-RTSG radiotherapy group, SIOP Europe board member for radiotherapy and former chair of the SIOP Europe Radiation Oncology Working Group.
The workshop is part of a PhD project made possible thanks to the partnership between the Máxima and the Hopp-KiTZ pediatric tumor center in Heidelberg, Germany and the Horizon Europe/Marie Sklodowska-Curie COFUND project number 101081481, the Prinses Máxima Center and the participating research groups and UMC Utrecht.