Editing Structures

Note: You must have Contour Patients permission for a workspace to edit structures for patients in that workspace.

Editing a Structure Set

  1. With a patient selected, choose the Structures tab.
  2. In the toolbar above the interactive viewer, press the Edit Structure Set button.

See below for further instructions on how to add, edit, and delete structures.

Exporting and Importing Structure Templates

While editing a structure set, press the export structure template button (denoted by a download icon) located in the toolbar at the top of the left sidebar. This will produce a CSV file, containing columns for the structure name, the structure type, and the RGB components of the structure color. Exported structure templates can then be imported (with modification if desired) using the procedure below to facilitate the standardization of structure names, types, and colors.

  1. While editing a structure set, press the import structure template button (denoted by the upload symbol) located in the toolbar at the top of the left sidebar.
  2. Use the Select File button to select a structure template file. Then use the radio buttons to select how structures with the same case-insensitive name should be handled.
  3. Press the Import button to import the structure templates.

Adding a Structure

  1. While editing a structure set, press the create structure button (denoted by the plus symbol) located in the left sidebar.
  2. Choose a Name, Type, and Color for the structure. Structure names must be 80 characters or less.
  3. Choose a creation Method. The Manually Contoured method creates an empty structure with no contours. The other methods allow you to clone existing structures, perform boolean operations on existing structures, and apply uniform margins to existing structures.
  4. Press the Create button to create the structure.

Editing a Structure

  1. While editing a structure set, choose the structure you wish to edit by clicking on it.
  2. In the row of tools that appears below the selected structure, select the edit button denoted by the pencil icon.
  3. Set the Name, Type, and Color for the structure.
  4. Press the Save button to save your changes.

Cloning a Structure

  1. While editing a structure set, choose the structure you wish to clone by clicking on it.
  2. In the row of tools that appears below the selected structure, select the clone button denoted by the clone icon. This will open the Create Structure dialog.
  3. Set the Name and Color for the structure (the Type, Method, and Structure to Clone will automatically be populated based on the selected structure).
  4. Press the Create button to create the structure.

Create a New Structure as Uniform Margin

  1. While editing a structure set, choose the structure you wish to use as the basis for the new, uniformly margined structure by clicking on it.
  2. In the row of tools that appears below the selected structure, select the "Create New Structure as Uniform Margin" button denoted by the expansion icon. This will open the Create Structure dialog.
  3. Set the NameColor, and Uniform Margin amount for the structure (the Type, Method, and Structure to Clone and Add Margin will automatically be populated based on the selected structure).
  4. Press the Create button to create the structure.

Deleting a Structure

  1. While editing a structure set, choose the structure that you wish to delete by clicking on it.
  2. Confirm that you wish to delete the structure by pressing the Remove button.

Updating Contours Using the Contouring Tools

While editing a structure set, click on a structure to select it. Then use the tools described below to edit the contours for the selected structure.

Draw

Click on the draw tool to activate it. With the draw tool activated, you can contour a structure in a point-and-click fashion or by clicking and dragging to draw a continuous line. To add to an existing contour, start from inside the contour and draw outwards. To remove from an existing contour, start from outside the contour and draw inwards. Toggle the default add/edit mode by holding down the Shift or Alt key. You must close each draw operation at the same point you began.

Smooth Lines

When using the draw mode, ProKnow automatically smooths your contour lines as your draw. If you would like to turn this feature off, press the dropdown arrow next to the draw tool, and toggle the Smooth Lines option off.

Paint

Click on the paint tool to activate it. With the paint tool activated, you can contour a structure by clicking and dragging the paintbrush across the image. Toggle the default add/edit mode by holding down the Shift or Alt key.

Paintbrush Options

To access the available paintbrush options, press the dropdown arrow next to the paint tool. Adjust the brush diameter using the input field or slider. Click on the Smooth Brush option to toggle the option on and off.

Interpolation

To interpolate between slices, click on the Interpolate button. Once clicked, ProKnow DS will attempt to generate contours for the current structure on all empty slices between slices containing contours. There are several situations in which warnings will be reported after the interpolation has completed. Please note that when these warnings are displayed, only the indicated range will have not been interpolated. Any other empty slices able to be interpolated will be completed. The most common warnings include:

  • Unable to interpolate between the slice at X.XX mm and the slice at Y.YY mm as the slices each contain multiple contours and the contour orientations are not consistent (most commonly caused by complex bifurcation scenarios). This is an uncommon case that can occur when attempting to interpolate between slices that have the same number of contours, but the orientations of the contours are not consistent from one slice to the other. For example, in the following images, you can see two slices, Slice A, which contains two contours: a circle and a hole; and Slice B, which also contains two contours: two circles. Please note that in both of these images, the "interior" portion of the contours have been slightly filled to aid in the visual distinction.
    interpolation-case1-sliceA.png
    interpolation-case1-sliceB.png
    In this case, the contour orientations between the two slices (1 CCW and 1 CW in Slice A and 2 CCW in Slice B) do not match, and indeed, there is no obvious solution for how to interpolate between these two slices.
  • Unable to interpolate between the slice at X.XX mm and the slice at Y.YY mm as no valid combination of overlapping contours could be found. This situation can occur when interpolating between slices that contain different numbers of contours. When there is a different number of contours from one slice to another, for example, between Slice A and Slice B below, ProKnow DS attempts to determine the most suitable pairwise combination of contours by looking at the overlapping area between all contours from one slice to another. ProKnow DS interpolates, in order of greatest overlapping area, from each contour on the first slice to the corresponding contour on the second slice. For example, when interpolating between Slice A and Slice B, ProKnow DS will interpolate the larger circle from Slice A to the single circle on Slice B since, if superimposed onto the same slice, their areas would overlap.
    interpolation-case2-sliceA.png
    interpolation-case2-sliceB.png
    However, when interpolating from Slice B to Slice C, the circles share no area in common and thus, ProKnow DS will report a warning when attempting to interpolate between these two slices.
    interpolation-case2-sliceC.png
    In general, it is always best to interpolate between highly similar slices, especially in cases where there are multiple contours present on each slice.

In addition to the warnings listed above, there are also several situations which can cause critical failures during interpolation. If you receive a message indicating that the "Interpolation Failed," then ProKnow DS encountered an error that prevented interpolation from completing. There are two cases where you may encounter errors during interpolation:

  • Slice at position X.XX mm contains contour data but does not exist in the slice position list. This can occur in rare cases where the source structure set was contoured on image slices that have not been uploaded to ProKnow DS. In other words, contour information exists outside of the visible range of the image set slices. In this case, double check that all image slices have been uploaded to ProKnow DS and try again.
  • Interpolation failed because ProKnow detected a mismatch in contour orientations between two slices. This is a rare case that can occur if there is an issue with the source contour data. Generally, it indicates that the source contour data is malformed or otherwise corrupt. Please contact ProKnow support and they can help investigate the issue.

Copying Contours

To copy from the previous slice, press the Copy from Previous Slice button. To copy from the next slice, press the Copy from Next Slice button.

Clearing Contours

To clear the current slice, press the Clear Current Slice button. To clear several slices at once, press the Clear Slices... button and choose from one of the available options ("Clear all," "Clear every other slice," and "Clear specific slices").

Managing Drafts

When you press the Edit Structure Set button, a structure set draft is created for you if one does not exist already. While editing a draft, the structure set remains locked from other edits, meaning that other users cannot edit the same structure set. Your contours are saved in the background as you edit.

When you are finished contouring, you have three options. If you would like to delete the draft completely, press the Delete Draft button. This operation is permanent and will discard all changes to the structure set. To save the draft without making it the current version of the structure set, press the Save as Draft & Close button. To save changes and make the draft the current version of the structure set, press the Commit. When you commit a structure set, you'll be prompted to give it an optional label and commit message.

Structure Set Locks and Inactivity Timeouts

Only one user can contour at a time. When a user begins to edit a structure set, the structure set becomes locked to other users. Other users may view the current or previous versions of the structure set, but they will not be able to edit the current draft until the user who is editing is finished. If there are no changes made to the structure set for 10 minutes, the structure set will be unlocked, and the user who is editing the structure set will be presented with a message giving you the option to either close the draft or continue contouring.

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