Computer Science > Computer Vision and Pattern Recognition
arXiv:2603.09448 (cs)
[Submitted on 10 Mar 2026]
Title: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
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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.
| Comments: | |
| Subjects: | Computer Vision and Pattern Recognition (cs.CV); Artificial Intelligence (cs.AI) |
| Cite as: | arXiv:2603.09448 [cs.CV] |
| (or arXiv:2603.09448v1 [cs.CV] for this version) | |
| https://doi.org/10.48550/arXiv.2603.09448
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View a PDF of the paper titled A Guideline-Aware AI Agent for Zero-Shot Target Volume Auto-Delineation, by Yoon Jo Kim and 9 other authors
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