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Contouring Accuracy: The Anorectum

Course Details

CEUs: 1.0

Available Until: 8/31/2019

Non-Member Price: $35.00

Member Price: $20.00

Member PLUS Price: $20.00

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Once you have exceeded your annual free credit allowance you will be prompted to pay a per-credit fee.

Courses purchased using your credit allowance are non-refundable and need to be completed before their expiration date

View your annual credit allowance here.

There are charges associated with this activity that will be processed when you access the ProKnow website. 

In order to participate in this activity, you must use one structure token in your ProKnow account. If you don't have a structure token you can obtain one by subscribing to the Contouring Accuracy Program (see

This program focuses on contouring accuracy and combines the use of educational media (documents and learning videos) with interactive contouring. It will measure the accuracy of drawn contours against a set of "gold standard" contours provided by an expert radiation oncologist. The focus of this particular training is the anorectum.

Why do we focus on contouring accuracy? Technology continues to advance in the area of radiation treatment planning and delivery, promising ever-increasing dose conformality and, more recently, planning automation aimed to limit variability and increase efficiency. However, no matter what new technologies are developed, they all rely on (i.e. they assume) high accuracy in the contouring of targets and organs-at-risk (OAR). If anatomic contouring lacks in precision or accuracy, then – no matter how conformal the dose appears, or how accurate the dose calculation is proven, or how high the quality of the plan in terms of meeting objectives – the reviewed and approved plans are not real. Therefore it is necessary that each planner has the best contouring skills possible.

Activity Instructions:

In order to complete this event and earn your CE credit, you should first associate your AAMD Member Login with your ProKnow account by following the instructions here - Once you’ve linked your AAMD account information to your ProKnow profile and obtained the required score, your transcript in the AAMD CE Center will be automatically updated to include the relevant course within 2-4 weeks of successful completion of each structure. If you have already done this, you may skip this step.

Next, in order to access a premium structure, you must spend one of your structure tokens, which you can obtain by subscribing to the program (see Find and select the anorectum instance for the month of August 2018, and access the structure instance using your structure token.

The Background tab provides information about the structure that you can use before you begin contouring. After you have reviewed this material you can move on to the Contour and Score tab.

The Contour and Score tab is where you will be performing your contouring. You can either use ProKnow's built-in contouring tool or download the CT images and upload a Structure Set created in your contouring tool of choice. When you're finished contouring, exit the contouring tools and click on Generate Score to submit your results. The time required to compute your results can vary - from only a couple seconds to a couple minutes - depending on the size of the structure. After you have reviewed your results, you can view the learning material and training videos on the Learn tab.

The Learn tab contains education specific to this patient dataset and the structure. Look over any documents and videos.

Please note that if you don't obtain a passing score on your first attempt, you may go to the "Redo and Practice" tab to try again to obtain a passing score of 75. Also, note that scores are sent every two weeks from ProKnow to the AAMD so your CE credit may not appear instantaneously.


Aaron Kusano, M.D., S.M.

- Dr. Kusano received his medical degree from the University of Washington School of Medicine where he also completed his residency in radiation oncology. As an undergraduate at Johns Hopkins University, he studied biomedical engineering with a focus on electrical engineering and a minor in mathematics. Following this, he received his master's degree in cancer epidemiology from the Harvard School of Public Health.

- Dr. Kusano has published and given talks and keynote addresses at national conferences, focusing on safety and quality in radiation oncology.