Nataliya Kovalchuk, Clinical Professor at Stanford Radiation Oncology, shared a post on LinkedIn:
“Our Manuscript on Automating Total Marrow Lymphoid Irradiation (TMLI) is published in Frontiers in Oncology!
Our Stanford Radiation Oncology team is excited to share our newly published study on automating TMLI — a step toward making this advanced technique faster, safer, and more accessible worldwide.
Why this matters:
TMLI can deliver higher, more targeted doses while sparing organs at risk — but historically, it’s been labor-intensive and complex. We set out to change that.
What we did:
- Developed and validated AI-contouring models using data from 50 patients (ages 2–64).
- Built automated planning scripts for low- and high-dose TMLI using the Varian Eclipse API.
- Automated plan checks to streamline safety and consistency.
- Released the scripts open-access to support multi-institutional studies and global standardization.
Key findings:
High-quality auto-contours
- DSC: 0.89 ± 0.03
- HD95: 3.38 ± 1.46 mm
- Reviewers rated contours nearly “acceptable as-is.”
Auto-plans matched or exceeded manual plans
- Dosimetric difference: –1.3% ± 5.9%
- Reviewers preferred or found auto-plans equivalent 74% of the time.
Massive gains in efficiency
- Manual: 2–3 days
- Automated: 4–5 hours
Substantial organ sparing vs. VMAT-TBI
- Average dose reduction: –34%
- 50% dose reduction to oral cavity, lenses, eyes, and salivary glands (all p ≤ 0.05)
Bottom line:
We created and validated a fully automated VMAT-TMLI workflow that maintains clinical quality while dramatically reducing planning time. By making our scripts public, we aim to accelerate clinical adoption, enhance patient safety, and support multi-institutional trials across the world.”
Title: Automated contouring, treatment planning, and quality assurance for total marrow lymphoid irradiation
Authors: Eric Simiele, Caressa Hui, Ignacio Romero, Zi Yang, Lawrie Skinner, Lei Xing, Jason B. Ross, Richard T. Hoppe, Michael S. Binkley, Susan M. Hiniker, Nataliya Kovalchuk
You can read the full article in Frontiers in Oncology.
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