{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T11:34:09Z","timestamp":1778672049129,"version":"3.51.4"},"reference-count":13,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2013,8,29]],"date-time":"2013-08-29T00:00:00Z","timestamp":1377734400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Med Imag Rad Onc"],"published-print":{"date-parts":[[2014,2]]},"abstract":"Abstract<\/jats:title>Purpose<\/jats:title>To evaluate interobserver variability in contouring lumbosacral plexuses (LSP<\/jats:styled-content>) using the protocol developed by Y<\/jats:styled-content>i et\u2009al<\/jats:italic>. (IJROBP<\/jats:styled-content> 2012; 84: 376\u201382) and to review LSP<\/jats:styled-content> dosimetries for conventional radiotherapy and intensity\u2010modulated radiotherapy (IMRT<\/jats:styled-content>) for pelvic cancers.<\/jats:p><\/jats:sec>Methods and materials<\/jats:title>Using the above\u2010mentioned protocol, seven outliners independently contoured LSPs<\/jats:styled-content> of 10 consecutive patients (five patients treated with conventional radiotherapy and five with IMRT<\/jats:styled-content>). Interobserver variability was reviewed visually by using planning axial CT images and anteroposterior digitally reconstructed radiographs. Dosimetries of LSPs<\/jats:styled-content> were also calculated and compared.<\/jats:p><\/jats:sec>Results<\/jats:title>There was a notable learning curve for each outliner; duration to outline the first patient was 45\u2013185 minutes, versus 15\u201350 minutes after six patients. We found significant interobserver variability among outliners below the level of the S2<\/jats:styled-content> nerve roots. The LSP<\/jats:styled-content> volumes (mean volume range of 40.9\u201358.4\u2009cc) were smaller than those described in the atlas paper (71\u2013138\u2009cc). The mean values of mean dose, maximum dose, V40\u2009Gy, V50\u2009Gy and V55\u2009Gy, respectively, for patients treated with conventional radiotherapy versus those treated with IMRT<\/jats:styled-content> were 35.5\u2009Gy versus 33.6\u2009Gy, 52.2\u2009Gy versus 52.2\u2009Gy, 61.3% versus 54.4%, 14.9% versus 18.8% and 0% versus 2.5%.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>We conclude that the protocol developed by Y<\/jats:styled-content>i et\u2009al<\/jats:italic>. is a useful set of guidelines but suggest that additional at\u2010risk components of the LSP<\/jats:styled-content> also be contoured. We recommend that radiation oncologists practise \u2018nerve\u2010sparing\u2019 radiotherapy by contouring LSPs<\/jats:styled-content>, especially when using IMRT<\/jats:styled-content>. We propose the term \u2018lumbosacral plexus regions\u2019 (LSPRs<\/jats:styled-content>) to highlight the fact that LSPs<\/jats:styled-content> are not always radiologically visible, only the regions where they are likely to be present.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1754-9485.12106","type":"journal-article","created":{"date-parts":[[2013,8,30]],"date-time":"2013-08-30T04:04:38Z","timestamp":1377835478000},"page":"117-124","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["External validation of the lumbosacral plexus\u2010contouring protocol developed by Y<\/scp>i et\u2009al<\/i>. (IJROBP<\/scp> 2012; 84: 376\u201382) for pelvic malignancies"],"prefix":"10.1111","volume":"58","author":[{"given":"Myo","family":"Min","sequence":"first","affiliation":[{"name":"Alan Walker Cancer Centre Royal Darwin Hospital Darwin Northern Territory Australia"},{"name":"Department of Radiation Oncology Royal Adelaide Hospital Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Roos","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Royal Adelaide Hospital Adelaide South Australia Australia"},{"name":"School of Medicine University of Adelaide Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elly","family":"Keating","sequence":"additional","affiliation":[{"name":"Alan Walker Cancer Centre Royal Darwin Hospital Darwin Northern Territory 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Territory Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siddhartha","family":"Baxi","sequence":"additional","affiliation":[{"name":"Alan Walker Cancer Centre Royal Darwin Hospital Darwin Northern Territory 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