Standard Imaging: Contouring Challenge 2.0 brings attention to quality, uniformity in anatomy contouring

CONTACT: Jack Borgo, Marketing Communications 608-824-7815 [email protected]

Middleton, Wisconsin, January 7, 2011 – Standard Imaging, Radiation Oncology Resources, Canis Lupus LLC and the American Association of Medical Dosimetrists (AAMD) successfully concluded the Contouring Challenge (CC) 2.0, an event created to bring attention to the fact that anatomy contouring remains a large source of variation/error in radiation oncology, on December 17, 2010.

During the CC 2.0, 21 participants downloaded uniform head and neck CT sets and delineated the larynx, submandibular glands, spinal cord, brainstem, parotids and brachioplexus within a set time limit. These completed contours were compared to “Gold ROIs” created by Dr. Eduardo Leon of Roswell Park Cancer Institute using Standard Imaging’s StuctSure Software, a tool used to generate quantitative comparisons of two DICOM RT image sets.

The top three contestants, (1st) Ren Wei from Singapore National University Hospital, (2nd) Jen Breunig from Loyola University Medical Center and (3rd) Theo Howard-Ames from St. Peter’s Cancer Care Center, each had several contours that were highly conformal to the “Gold ROIs”, scoring 90 or above (out of a possible 100). Although these clinicians’ delineations closely resembled the “Gold ROIs”, the overall results revealed stark differences between the size and shape of contours from participant to participant.

“We’ve seen several trends emerge during the [Contouring] Challenges and, unfortunately, high variability between clinicians is one of them,” said Neal Miller, Product Manager at Standard Imaging and co-host of the Contouring Challenge 2.0. “Though this is just a small sampling, we hope that our results can spur some conversations about the way we train, teach and share proper delineation tactics.”

Data gathered during the CC 2.0, along with results from previous Contouring Challenges, was used to facilitate discussions about best practices and trends in clinical contouring during the CC 2.0 Results Webinar on December 17th. 140 RT Professionals logged on to the Results Webinar to hear presentations from industry representatives and contouring experts on the need for improved, consistent quality in the delineation of critical structures.

Dr. James Wheeler MD, PhD of Center for Cancer Care at Goshen, John Roeske PhD of Loyola University Medical Center, Greg Robinson CMD of Radiation Oncology Resources and Ben Nelms PhD and Founder of Canis Lupus LLC, spoke at the Results Webinar.

“We might be able to achieve some very cost-effective boosts in quality in our field by going back to the basics and investing in staff training, starting with anatomy contouring,” said Nelms. “After all, if we don’t
define the structures right, it doesn’t matter as much what planning and delivery equipment we use. On the other hand, if we do define the structures with great accuracy and consistency, we can truly reach the potential of the big ticket technology investments.”

To learn more about the Contouring Challenge 2.0, or previous Contouring Challenges, visit

About The Contouring Challenge:

The Contouring Challenge (CC), a collaboration between Standard Imaging Inc., the American Association of Medical Dosimetrists (AAMD), Radiation Oncology Resources (ROR) and Canis Lupus LLC, is an opportunity to engage the industry and press for practical, cost-effective quality systems for anatomy contouring that may eventually improve the standards of care worldwide. Several institutions, such as Loyola University (Chicago) and London Regional (London, Ontario) have already begun studying contouring quality systems using the StructSure Software as the backbone for quantifying variation and performance versus gold standards.

One of the first steps in testing training/quality systems is to assess, “Where are we today?” The Contouring Challenge and its participants can help answer this question.

About Standard Imaging:

Standard Imaging is a leading manufacturer of radiation calibration and quality assurance instruments for healthcare. The company was founded in 1989, and has continually grown to become a leader in the medical physics field. For more information, please visit or contact Standard Imaging at 608-831-0025