Update of the EPTN atlas for CT- and MR-based (3T and 7T) contouring in Neuro-Oncology

Background and purpose:To update the digital online atlas for organs at risk (OARs) delineation in neuro-oncology based on high-quality computed tomography (CT) and magnetic resonance (MR) imaging withnew OARs.Materials and methods:In this planned update of the neurological contouring atlas published in 2018, tennew clinically relevant OARs were included, after thorough discussion between experienced neuro-radiation oncologists (RTOs) representing 30 European radiotherapy-oncology institutes. Inclusion wasbased on daily practice and research requirements. Consensus was reached for the delineation after crit-ical review. Contouring was performed on registered CT with intravenous (IV) contrast (soft tissue & bonewindow setting) and 3 Tesla (T) MRI (T1 with gadolinium & T2 FLAIR) images of one patient (1 mm slices).For illustration purposes, delineation on a 7 T MRI without IV contrast from a healthy volunteer wasadded. OARs were delineated by three experienced RTOs and a neuroradiologist based on the relevant lit-erature.Results:The presented update of the neurological contouring atlas was reviewed and approved by 28experts in the field. The atlas is available online and includes in total 25 OARs relevant to neurooncology, contoured on CT and MRI T1 and FLAIR (3 T & 7 T). Three-dimensional (3D) rendered films arealso available online.Conclusion:In order to further decrease inter- and intra-observer OAR delineation variability in the fieldof neuro-oncology, we propose the use of this contouring atlas in photon and particle therapy, in clinicalpractice and in the research setting. The updated atlas is freely available onwww.cancerdata.org.