Limited imaging modalities
The study only included planning CT scans, excluding MRI and PET scans, which are necessary for optimal delineation of certain organs at risk, like the optic chiasm.
Omission of certain organs at risk
While the study included a large set of organs at risk, some important ones, like the oral cavity, were omitted due to insufficient training data, potentially affecting the model's comprehensiveness.
Limited oncologist involvement in ground truth creation
The limited number of oncologists used for ground truth creation might not fully represent the variability in organ at risk segmentation, potentially introducing bias into the evaluation process.
Lack of protected-characteristic data
The lack of patient protected-characteristic status prevents analysis of intersectional fairness, limiting the understanding of potential biases in the model's performance across different demographic groups.
Lack of time-saving analysis
The study doesn't include an analysis of the time-saving potential of the model in a real-world radiotherapy planning workflow, making it difficult to assess its practical impact on clinical practice.