You are on page 1of 6

Article Comparison : Trade Publication vs.

Peer Reviewed Article


Reisha Willis
Part I: Trade Publication
When researching articles in a particular field, there are different types of publications to choose
from and each have benefits depending on your preference and need. Trade publications and
peer-reviewed journals are two types to choose from and there is a clear difference in each
publication. Trade publications are written by members of a specific business, industry or
organization and they depict industry trends and new products. While this type of publication is
not considered "peer-reviewed", it is however reviewed by an editorial board for accountability.
The trade magazine article I chose is titled Tumor Autocontouring - Efficiently Maximizing Dose
and Minimizing Damage to Healthy Tissue by Mark Klincewicz, BME. I will provide a brief
summary of the article and describe how this article relates to myself in the medical dosimetry
field as well as others in radiation oncology.
This article describes the new technology available to contour patients more accurately
with less time spent by the physician and dosimetrist such as autocontouring and
autosegmentation, auto fusion, and the 3D SmartBrush and SmartShaper that helps in the
contouring process. Autocontouring and autosegmentation is the ability to take a new patient's
CT dataset and have the computer automatically contour critical structures by pulling from a
database of 50-100 patients and achieving within a 1mm accuracy. He also discussed the
technology of a 3D smart brush that is able to contour the first and last slice and the computer
creates a linear interpolation to give a 3D display.
This article is interesting in that it refers to the first and most important part of the
planning process, the tumor and healthy tissue contouring. The dose recorded to normal tissues
in a patient's plan relies on the accuracy of the contours drawn. The author explained at the
beginning of the article that images containing many kinds of tissues (eg, dense breast tissue,
ducts, blood vessels) other than tumors, as well as noise, make it difficult to mark the target
using just simple edge manual techniques. He also brought up points that manual contouring is
both subjective and time consuming. Autocontouring and autosegmentation is a technology that I
have been able to experience in clinic but with a different software company. The accuracy of the
autosegmentation is only achievable if there are enough patient's contoured in the same position

in the atlases. My question would be, does the software come with these datasets already
contoured? Velocity is the software we use and we are responsible for entering patients in each
atlas. After 6 months of using this new contouring software we still are not able to use the auto
function due to not having enough information to give an accurate contour.
This article has both strengths and weaknesses in its ability to describe the new
technologies. It did a great job of explaining the importance of contouring and the reason why
the need for new technologies is important. It does fall short in explaining the details, though.
For example, it discussed automatic fusion of a brain tumor to multiple datasets such as PET,
MR, and CT. But with the difference in patients positions it is important to focus on where the
tumor is or a critical structure is located. I wish this article would have explained more about the
method in which the automatic fusions are used. How accurate is it? When contouring a brain
lesion that is being treated with stereotactic radiosurgery and is fused to an MRI, fusion accuracy
is extremely important. The viewpoint of the author was clearly one of a person that is not in the
radiation oncology field.

References
1. Popular Magazines vs. Trade Magazines vs. Scholarly Journals. Colorado State
University Libraries Web Site. http://lib.colostate.edu/howto/poplr.html. Accessed March
24, 2015.
2. Klincewicz, M. (2009, June 1). Tumor autocontouring - efficiently maximizing dose and
minimizing damage to healthy tissue. Radiology Today, (10)11,22. Retrieved from
http://www.radiologytoday.net/archive/rt060109p22.shtml

Part II: Peer Reviewed Research Article


Peer review research articles provide information to professionals in the field on a
particular subject relevant to a discipline. "Peer review" refers to the policy of having experts in
the field examine journal articles before acceptance for publication. Peer review insures that the
research described in a journal's articles is sound and of high quality These articles are reviewed
by researchers and professionals in the field. There are ways to tell quickly if it is a peer
reviewed publication. This type of research has a hypothesis and conclusion and it is found in
one of the databases that includes scholarly publication. The article I chose to analyze is from the
Medical Dosimetry journal and is titled An efficient Volumetric Arc Therapy treatment planning
approach for hippocampal-avoidance whole-brain radiation therapy (HA-WBRT) written by
Shen J, Bender E, Yaparpalvi R, et al from the department of Radiation Oncology at Montefiore
Medical Center and the University of Wisconsin, Madison. I will investigate all aspects of this
article and describe how the hypothesis was presented and the research was carried out.
Patients who are considered for WBRT have multiple brain metastases and a poor
prognosis. Treatment options are limited for these patients which is why the potential toxicities
resulting from WBRT were largely dismissed. Now with advances in patient survival, there is a
need to reduce these toxicities to better the patients' quality of life. The hippocampus is a small
organ located within the brain's medial temporal lobe and forms an important part of the limbic
system, the region that regulates emotions. It is associated mainly with memory, in particular
long-term memory. The organ also plays an important role in spatial navigation. Due to its
location in the middle of the brain, it makes it difficult to avoid when planning WBRT. The
RTOG 0933 trial indicates that the use of intensity-modulated radiotherapy technique that avoids
radiation dose to the hippocampus during HA-WBRT could be beneficial in preserving memory.
This article described a planning technique that used volumetric arc therapy (VMAT) to
avoid the hippocampus while still delivering dose to cover the entire brain. The study took 20
patient data sets were planned using a partial-field dual arc technique that met the NRG-CC001
protocol dose-volume criteria. The brain was divided into 3 PTV volumes and the isocenter was
located in the center of the hippocampus. The results showed that the use of the partial-field
dual-arc technique allows one to generate a uniform dose distribution in the part of the wholebrain PTV that lies out of the plane of the hippocampal-avoidance region, whereas the dose

distribution is more homogeneous in the planning target sub volume that contains the avoidance
area.
It was apparent that this study proved its hypothesis and the plan generated would be
extremely helpful in the planning process. This article was drastically different than the first in
that it suggested a problem and come up with a solution that was reviewed by experts in the
field. It went into the details that you need to know when planning instead of the first article,
which brushed over a topic. This publication published an article of a study that was well carried
out and answered a specific question. I agree that this publication would greatly benefit myself as
well as others in the radiation oncology field.

References
1. Suh, J. Hippocampal-avoidance whole-brain radiatin therapy: a new standard for patients
with brain metastases. J Clin Oncol Res.2014;32(34)3789-3791.
http://dx.doi:10.1200/JCO.2014.58.4367.
2. Mandal,A. Hippocampus Funtions. News Medical website http://www.newsmedical.net/health/Hippocampus-Functions.aspx.Accessed March 25, 2015.
3. Shen J, Bender E, Yaparpalvi R, et al. An efficient volumetric arc therapy treatment
planning approach for hippocampal-avoidance whole-brain radiation therapy
(HA_WBRT). Med Dosim. 2015: http://dx.doi.org/10.1016/j.meddos.2014.11.007

You might also like