Paper
A Guideline-Aware AI Agent for Zero-Shot Target Volume Auto-Delineation
Authors
Yoon Jo Kim, Wonyoung Cho, Jongmin Lee, Han Joo Chae, Hyunki Park, Sang Hoon Seo, Noh Jae Myung, Kyungmi Yang, Dongryul Oh, Jin Sung Kim
Abstract
Delineating the clinical target volume (CTV) in radiotherapy involves complex margins constrained by tumor location and anatomical barriers. While deep learning models automate this process, their rigid reliance on expert-annotated data requires costly retraining whenever clinical guidelines update. To overcome this limitation, we introduce OncoAgent, a novel guideline-aware AI agent framework that seamlessly converts textual clinical guidelines into three-dimensional target contours in a training-free manner. Evaluated on esophageal cancer cases, the agent achieves a zero-shot Dice similarity coefficient of 0.842 for the CTV and 0.880 for the planning target volume, demonstrating performance highly comparable to a fully supervised nnU-Net baseline. Notably, in a blinded clinical evaluation, physicians strongly preferred OncoAgent over the supervised baseline, rating it higher in guideline compliance, modification effort, and clinical acceptability. Furthermore, the framework generalizes zero-shot to alternative esophageal guidelines and other anatomical sites (e.g., prostate) without any retraining. Beyond mere volumetric overlap, our agent-based paradigm offers near-instantaneous adaptability to alternative guidelines, providing a scalable and transparent pathway toward interpretability in radiotherapy treatment planning.
Metadata
Related papers
Gen-Searcher: Reinforcing Agentic Search for Image Generation
Kaituo Feng, Manyuan Zhang, Shuang Chen, Yunlong Lin, Kaixuan Fan, Yilei Jian... • 2026-03-30
On-the-fly Repulsion in the Contextual Space for Rich Diversity in Diffusion Transformers
Omer Dahary, Benaya Koren, Daniel Garibi, Daniel Cohen-Or • 2026-03-30
Graphilosophy: Graph-Based Digital Humanities Computing with The Four Books
Minh-Thu Do, Quynh-Chau Le-Tran, Duc-Duy Nguyen-Mai, Thien-Trang Nguyen, Khan... • 2026-03-30
ParaSpeechCLAP: A Dual-Encoder Speech-Text Model for Rich Stylistic Language-Audio Pretraining
Anuj Diwan, Eunsol Choi, David Harwath • 2026-03-30
RAD-AI: Rethinking Architecture Documentation for AI-Augmented Ecosystems
Oliver Aleksander Larsen, Mahyar T. Moghaddam • 2026-03-30
Raw Data (Debug)
{
"raw_xml": "<entry>\n <id>http://arxiv.org/abs/2603.09448v1</id>\n <title>A Guideline-Aware AI Agent for Zero-Shot Target Volume Auto-Delineation</title>\n <updated>2026-03-10T10:00:01Z</updated>\n <link href='https://arxiv.org/abs/2603.09448v1' rel='alternate' type='text/html'/>\n <link href='https://arxiv.org/pdf/2603.09448v1' rel='related' title='pdf' type='application/pdf'/>\n <summary>Delineating the clinical target volume (CTV) in radiotherapy involves complex margins constrained by tumor location and anatomical barriers. While deep learning models automate this process, their rigid reliance on expert-annotated data requires costly retraining whenever clinical guidelines update. To overcome this limitation, we introduce OncoAgent, a novel guideline-aware AI agent framework that seamlessly converts textual clinical guidelines into three-dimensional target contours in a training-free manner. Evaluated on esophageal cancer cases, the agent achieves a zero-shot Dice similarity coefficient of 0.842 for the CTV and 0.880 for the planning target volume, demonstrating performance highly comparable to a fully supervised nnU-Net baseline. Notably, in a blinded clinical evaluation, physicians strongly preferred OncoAgent over the supervised baseline, rating it higher in guideline compliance, modification effort, and clinical acceptability. Furthermore, the framework generalizes zero-shot to alternative esophageal guidelines and other anatomical sites (e.g., prostate) without any retraining. Beyond mere volumetric overlap, our agent-based paradigm offers near-instantaneous adaptability to alternative guidelines, providing a scalable and transparent pathway toward interpretability in radiotherapy treatment planning.</summary>\n <category scheme='http://arxiv.org/schemas/atom' term='cs.CV'/>\n <category scheme='http://arxiv.org/schemas/atom' term='cs.AI'/>\n <published>2026-03-10T10:00:01Z</published>\n <arxiv:comment>Submitted to MICCAI 2026</arxiv:comment>\n <arxiv:primary_category term='cs.CV'/>\n <author>\n <name>Yoon Jo Kim</name>\n </author>\n <author>\n <name>Wonyoung Cho</name>\n </author>\n <author>\n <name>Jongmin Lee</name>\n </author>\n <author>\n <name>Han Joo Chae</name>\n </author>\n <author>\n <name>Hyunki Park</name>\n </author>\n <author>\n <name>Sang Hoon Seo</name>\n </author>\n <author>\n <name>Noh Jae Myung</name>\n </author>\n <author>\n <name>Kyungmi Yang</name>\n </author>\n <author>\n <name>Dongryul Oh</name>\n </author>\n <author>\n <name>Jin Sung Kim</name>\n </author>\n </entry>"
}