Research Organization Document

Phase I

1. What philosophical foundation you are pursuing? Why?

We are primarily pursuing the philosophy of logical positivism for our research project.
The reason for this we prefer the data to be clear, concise, and unbiased. We believe this
will make our data more concretely validate or disprove our hypothesis. If we are able to
pursue the topic of contour delineation, there will definitely be a naturalistic factor
involved since the data will reflect the experience and perception of the practitioner
performing the contour delineation.

2. What is your topic idea? What is the problem you can solve?
The topic is Hippocampal Sparing in PCI patients and the problem is that contouring of
the hippocampus by credentialed dosimetric planners varies widely from the true
hippocampus due to disparate techniques and lack of anatomical knowledge.

3. Supporting Peer Reviewed Articles

1. Turner BE, Prabhu RS, Burri SH, et al. Nodular leptomeningeal disease - a distinct
pattern of recurrence after postresection stereotactic radiosurgery for brain metastases: a
multi-institutional study of interobserver reliability. Int J Radiat Oncol Biol Phys.
2020;106(3):579-586. http://dx.doi.org/10.1016/j.ijrobp.2019.10.002
2. Gondi V M.D., Tolakanahalli R M.S., Meta MP, et al. Hippocampal sparing: whole
brain radiotherapy a “how-to” technique, utilizing helical tomotherapy and linac-based
intensity modulated radiotherapy. Int J Radiat Oncol Biol Phys. 2010;78(4):1244–1252.
http://dx.doi.org/10.1016/j.ijrobp.2010.01.039
3. Vinod SK, Min M, Jameson MG, Holloway LC. A review of interventions to reduce
inter-observer variability in volume delineation in radiation oncology. J Med Imag Radiat
Oncol. 2016;60:393–406. http://dx.doi.org/10.1111/1754-9485.12462
 4. Grabarz D, Panzarella T, Bezjak A, et al. Quantifying interobserver variation in target
definition in palliative radiotherapy. Int J Radiat Oncol Biol Phys. 2011;80:1498–1504.
http://dx.doi.org/ 10.1016/j.ijrobp.2010.04.014
5. Peters LJ, O’Sullivan B, Giralt J, et al. Critical impact of radiotherapy protocol
compliance and quality in the treatment of advanced head and neck cancer: results from
TROG 02.02. J Clin Oncol. 2010;28:2996–3001.
http://dx.doi.org/10.1200/JCO.2009.27.4498
6. Vinod S, Jameson M, Min M, et al. Uncertainties in volume delineation in radiation
oncology: A systematic review and recommendations for future studies. Radiother Oncol.
2016;121(2): 169-179. http://dx.doi.org/10.1016/j.radonc.2016.09.009
7. NRG-CC003. NRG. https://www.nrgoncology.org/Clinical-Trials/Protocol/nrg-
cc003?filter=nrg-cc003. Published December 7, 2015. Accessed March 10, 2020.
8. Gondi V, Tome WA, Rowley HA, Mehta MP. Hippocampal Contouring: A
Contouring Atlas for RTOG 0933. Hippocampal Sparing.
https://www.rtog.org/CoreLab/ContouringAtlases/HippocampalSparing.aspx. Accessed
April 5, 2020.

4. What are your supporting questions?

1. What is the purpose of hippocampal sparing in PCI patients?

2. What is the current accepted method of delineating the hippocampus?

3. What factors influence variation in hippocampal delineation amongst practitioners?

4. Is the variance in hippocampal delineation statistically relevant for PCI patients?

5. Is the variance in hippocampal delineation limited to institution, and if not, how does it
vary?

6. Is the variance in hippocampal delineation limited to professional scope?

7. Does introducing delineation tools help decrease the variance in hippocampal

delineation?
5. What type of research design are you interested in pursuing with this topic?

We are interested in pursuing and experimental/quantitative design for our research. We plan on
using a control study as a base line to compare our data. We also plan on having groups that can
be divided by professional title and institution. Data will be collected from these groups pre and
post technique (atlas) introduction.