The Effect of Contrast Agents on Dose Calculations of Volumetric Modulated Arc Radiotherapy Plans for Critical Structures
and Mukhtar Alshanqity 1,*Round 1
Reviewer 1 Report
Report of Manuscript applsci-1359049 for Applied Sciences
Title: The Effect of Contrast Agents on Dose Calculations of Volumetric Modulated Arc Radiotherapy Plans for Critical Structures by Abou-Saleh Elawadi et al.
This article investigates contrast enhanced computed tomography imaging in radiotherapy, highlighting the impact of contrast materials on CT numbers and dose calculations in comparison to non-contrast CT imaging, justifying the use of contrast enhanced CT imaging to improve utilization and efficiency in radiotherapy simulation.
The article is clear and well written, and the authors prove to be skilled in the subject. Citations from the scientific literature are modern, appropriate and adequately integrated into the manuscript.
The manuscript standards are adequate with those of "applied science".
The manuscript will have a medium impact, in my opinion.
No serious issues are to be reported; hence I recommend the paper for publication after some minor comments.
-The introduction could be shortened
-The discussion section is very poor. I suggest the authors to increase it. The authors need to add more comparison with statistical analyzes.
-Number the different sections consistently.
-Improve the size of Table 3.
-Different minor typo-corrections that should be performed.
Author Response
Dear reviewer:
Thank you for your affirmation of our manuscript, we are grateful to your comments. We have made amendments to relevant parts in accordance with your advice.
Answers to the comments are below.
Regards,
Comment:
This article investigates contrast enhanced computed tomography imaging in radiotherapy, highlighting the impact of contrast materials on CT numbers and dose calculations in comparison to non-contrast CT imaging, justifying the use of contrast enhanced CT imaging to improve utilization and efficiency in radiotherapy simulation.
Response:
We would like to thank you for your time taken to review our manuscript, and the clear understanding, description, and constructive criticism.
Comment:
The article is clear and well written, and the authors prove to be skilled in the subject. Citations from the scientific literature are modern, appropriate and adequately integrated into the manuscript.
Response:
Thank you for the positive feedback.
Comment:
The manuscript standards are adequate with those of "applied science".
Response:
Thank you for the positive feedback.
Comment:
The manuscript will have a medium impact, in my opinion.
Response:
Thank you for the positive feedback.
Comment:
No serious issues are to be reported; hence I recommend the paper for publication after some minor comments.
Response:
Thank you for the positive feedback.
Comment:
-The introduction could be shortened
Response:
The introduction is improved without compromising literature review. A large number of published work directly related to the topic is cited in the manuscript which necessitate an extensive introduction.
Comment:
-The discussion section is very poor. I suggest the authors to increase it. The authors need to add more comparison with statistical analyzes.
Response:
Thank you for the comment, indeed the discussion section is compact and needs to be cover all results in addition to comparative literature review. It had been amended accordingly.
Comment:
-Number the different sections consistently.
Response:
Thank you for the comment, indeed “Results” section was numbered incorrectly. It is corrected now.
Comment:
-Improve the size of Table 3.
Response:
Thank you for the comment, we agree that “Table 3” is overloaded with data and difficult to read. The data represented in “Table 3” is distributed in three separate tables, Brain and H&N, Chest, and Abdomen and Pelvis.
Comment:
-Different minor typo-corrections that should be performed.
Response:
Thank you for the comment, the manuscript is thoroughly proofread by a professional.
Author Response File: 
Author Response.docx
Reviewer 2 Report
This study is to justify the use of contrast enhanced CT imaging to improve utilization and efficiency in radiotherapy simulation. Howerver, the topic is not novel.
General comments:
Introduction needs to be rewritten. The Introduction is unnecessarily lengthy. There is too much unnecessary information, while some important terms and information are left unexplained.
The authors should consider changing the scale in Table 3 to provide better visualization of the data.
Overall, A major re-write is required, focusing on the important results in the results section, and interpreting them in the Discussion section.
Author Response
Dear reviewer:
Thank you for your reviewing our manuscript, we are grateful to your comments. We have made changes to the manuscript in accordance with reviewer’s advice, we have amended the relevant parts and explained them as clearly as possible.
Answers to the comments are listed below.
Regards,
Comment:
This study is to justify the use of contrast enhanced CT imaging to improve utilization and efficiency in radiotherapy simulation. Howerver, the topic is not novel.
Response:
We would like to thank you for the time taken to review our manuscript and the constructive criticism. Indeed, the effect of contrast media on radiology image quality and radiotherapy dose calculation is discussed extensively in the literature, please see Table 1 in the original manuscript. However, many centers still obtain both contrast and non-contrast CT images. The aim of this work is to assess a much larger patient cohort covering multiple cancer sites than previous studies to confirm previous findings. We have tried to clarify the novelty and usefulness of the paper within the text.
Comment:
Introduction needs to be rewritten.
Response:
The introduction was carefully reviewed and rewritten as appropriate.
Comment:
The Introduction is unnecessarily lengthy.
Response:
The introduction is shortened and improved without compromising a review of the existing literature, which helps place the work in context.
Comment:
There is too much unnecessary information, while some important terms and information are left unexplained.
Response:
AAPM, IPEM, and 3DCRT acronyms were explained. The manuscript was carefully reviewed with emphasis on clarity and accuracy,
Comment:
The authors should consider changing the scale in Table 3 to provide better visualization of the data.
Response:
Thank you for the comment, we agree that “Table 3” is overloaded with data and difficult to read. The data represented in “Table 3” will be distributed in separate tables for each site.
Comment:
Overall, A major re-write is required, focusing on the important results in the results section, and interpreting them in the Discussion section
Response:
Thank you for the comment, indeed the discussion section is compact and needs to be more elaborate and cover all results in addition to comparative literature review. It has been amended accordingly.
Author Response File: Author Response.docx
Round 2
Reviewer 2 Report
The authors have provided adequate responses to this reviewer's requests, and have modified the paper accordingly. Thank you for your edits to the manuscript.
