Clinical validation of AI‐assisted contouring in prostate radiation therapy treatment planning: Highlighting automation bias and the need for standardized quality assurance

Abstract

AI-assisted contouring in prostate radiotherapy reduced intra- and inter-observer variability and improved contouring consistency. However, C_{AI, adj} did not consistently surpass C_man, especially for the CTV and rectum, where automation bias or selective clinical acceptance may have influenced edits. Fixed-plan recalculations revealed dose differences from minor geometric deviations. These findings underscore the importance of structured quality assurance (QA) and human oversight to mitigate automation bias while leveraging AI's efficiency. The single-institution design with two oncologists and one AI software limits generalizability, underscoring the need for multi-observer validation.

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