CT Based Prostate Cancer Contouring Guided by AI Verification

Prostate cancer is one of the most common cancers worldwide and remains a significant cause of cancer-related death. With increasing life expectancy, its incidence is projected to rise steadily in the coming years. Radiation therapy plays a central role in the definitive management of patients with localized prostate cancer who do not undergo prostatectomy.
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In many low- and middle-income countries (LMICs), CT-based radiation planning is the only available option due to limited access to diagnostic magnetic resonance imaging (MRI) and MRI simulators. However, the poor soft tissue contrast of CT makes it challenging to accurately contour the prostate, leading to inter-physician variability in treatment planning. This variability may contribute to higher risks of radiation-related toxicities or cancer recurrence.
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Although contouring guidelines exist—such as those developed by the European Organisation for Research and Treatment of Cancer (EORTC) in 2006 and the ESTRO consensus panel in 2018—there remain no standardized CT-based contouring recommendations tailored to LMICs. The absence of such guidelines continues to be a barrier to ensuring consistent, high-quality radiation treatment in these settings.
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Purpose
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This project aims to establish and publish CT-based prostate contouring guidelines. In addition, an artificial intelligence (AI) contouring tool will be developed to enhance contouring accuracy, consistency, and efficiency. Together, these efforts seek to strengthen radiation oncology practices in LMICs and improve prostate cancer treatment outcomes where MRI capabilities are not available.
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