Ellen Donovan

Dr Ellen Donovan

Visiting Professor
+44 (0)1483 689340
02 PGM 00


My qualifications

BA (Hons) Natural Sciences
University of Cambridge
MSc Medical Physics
University of Aberdeen
Institute of Cancer Research, University of London


Research interests

Indicators of esteem

  • National Institute of Health Research (NIHR) Mentor for Clinical Academics


Postgraduate research supervision

My teaching

My publications


The results in this Lancet publication are practice changing for radiotherapy for breast cancer.

IMPORT LOW trial): 5-year results from a multicentre, randomised, controlled, phase 3, non-inferiority trial’

Coles CE, Griffin CL, Kirby AM, Titley J, Agrawal RK, Alhasso A, Bhattacharya I,  Brunt A, Ciurlionis L, Chan C, Donovan EM et al and IMPORT Trialists

Lancet 390(10099) 1048-1060 2017



Journal Editor’s Pick for October 2012  and in top 10 most downloaded papers for September 2012 and October 2012

Second Cancer Incidence Risk Estimates using BEIR VII Models for Standard and Complex External Beam Radiotherapy for Early Breast Cancer’

Donovan EM, James H, Bonora M, Yarnold JR, Evans PM

Medical Physics 39 (10), 5814-24 (2012); http://dx.doi.org/10.1118/1.4748332 

Online Publication Date: 11 September 2012



Bartlett F, Carr K, McNair H, Locke I, Yarnold J, Kirby A, Colgan R, Donovan E, Evans P, Haviland J (2013) The UK HeartSpare Study: Randomised evaluation of voluntary deep-inspiratory breath-hold in women undergoing breast radiotherapy,Radiotherapy and Oncology 108 (2) pp. 242-247 Elsevier Ireland Ltd
Purpose To determine whether voluntary deep-inspiratory breath-hold (v-DIBH) and deep-inspiratory breath-hold with the active breathing coordinator" (ABC-DIBH) in patients undergoing left breast radiotherapy are comparable in terms of normal-tissue sparing, positional reproducibility and feasibility of delivery. Methods Following surgery for early breast cancer, patients underwent planning-CT scans in v-DIBH and ABC-DIBH. Patients were randomised to receive one technique for fractions 1-7 and the second technique for fractions 8-15 (40 Gy/15 fractions total). Daily electronic portal imaging (EPI) was performed and matched to digitally-reconstructed radiographs. Cone-beam CT (CBCT) images were acquired for 6/15 fractions and matched to planning-CT data. Population systematic (£) and random errors (Ã) were estimated. Heart, left-anterior-descending coronary artery, and lung doses were calculated. Patient comfort, radiographer satisfaction and scanning/treatment times were recorded. Within-patient comparisons between the two techniques used the paired t-test or Wilcoxon signed-rank test. Results Twenty-three patients were recruited. All completed treatment with both techniques. EPI-derived £ were d1.8 mm (v-DIBH) and d2.0 mm (ABC-DIBH) and à d2.5 mm (v-DIBH) and d2.2 mm (ABC-DIBH) (all p non-significant). CBCT-derived £ were d3.9 mm (v-DIBH) and d4.9 mm (ABC-DIBH) and à d 4.1 mm (v-DIBH) and d 3.8 mm (ABC-DIBH). There was no significant difference between techniques in terms of normal-tissue doses (all p non-significant). Patients and radiographers preferred v-DIBH (p = 0.007, p = 0.03, respectively). Scanning/treatment setup times were shorter for v-DIBH (p = 0.02, p = 0.04, respectively). Conclusions v-DIBH and ABC-DIBH are comparable in terms of positional reproducibility and normal tissue sparing. v-DIBH is preferred by patients and radiographers, takes less time to deliver, and is cheaper than ABC-DIBH. © 2013 Elsevier Ireland Ltd. All rights reserved.
Bartlett FR, Donovan Ellen, McNair HA, Corsini LA, Colgan RM, Evans Philip, Maynard L, Griffin C, Haviland JS, Yarnold JR, Kirby AM (2016) The UK HeartSpare Study (Stage II): Multicentre Evaluation of a Voluntary Breath-hold Technique in Patients Receiving Breast Radiotherapy,Clinical Oncology 29 (3) pp. e51-e56 Elsevier
Aims To evaluate the feasibility and heart-sparing ability of the voluntary breath-hold (VBH) technique in a multicentre setting. Materials and methods Patients were recruited from 10 UK centres. Following surgery for early left breast cancer, patients with any heart inside the 50% isodose from a standard free-breathing tangential field treatment plan underwent a second planning computed tomography (CT) scan using the VBH technique. A separate treatment plan was prepared on the VBH CT scan and used for treatment. The mean heart, left anterior descending coronary artery (LAD) and lung doses were calculated. Daily electronic portal imaging (EPI) was carried out and scanning/treatment times were recorded. The primary end point was the percentage of patients achieving a reduction in mean heart dose with VBH. Population systematic (£) and random errors (Ã) were estimated. Within-patient comparisons between techniques used Wilcoxon signed-rank tests. Results In total, 101 patients were recruited during 2014. Primary end point data were available for 93 patients, 88 (95%) of whom achieved a reduction in mean heart dose with VBH. Mean cardiac doses (Gy) for free-breathing and VBH techniques, respectively, were: heart 1.8 and 1.1, LAD 12.1 and 5.4, maximum LAD 35.4 and 24.1 (all P
Bartlett F, Colgan R, Donovan E, McNair H, Carr K, Evans P, Griffin C, Locke I, Haviland J, Yarnold J, Kirby A (2014) The UK Heart Spare Study (Stage IB): Randomised comparison of a voluntary breath-hold technique and prone radiotherapy after breast conserving surgery,Radiotherapy and Oncology 114 (1) pp. 66-72 Elsevier Ireland Ltd.

To compare mean heart and left anterior descending coronary artery (LAD) doses (NTDmean) and positional reproducibility in larger-breasted women receiving left breast radiotherapy using supine voluntary deep-inspiratory breath-hold (VBH) and free-breathing prone techniques.

Materials and methods

Following surgery for early breast cancer, patients with estimated breast volumes >750 cm3 underwent planning-CT scans in supine VBH and free-breathing prone positions. Radiotherapy treatment plans were prepared, and mean heart and LAD doses were calculated. Patients were randomised to receive one technique for fractions 1?7, before switching techniques for fractions 8?15 (40 Gy/15 fractions total). Daily electronic portal imaging and alternate-day cone-beam CT (CBCT) imaging were performed. The primary endpoint was the difference in mean LAD NTDmean between techniques. Population systematic (£) and random errors (Ã) were estimated. Within-patient comparisons between techniques used Wilcoxon signed-rank tests.


34 patients were recruited, with complete dosimetric data available for 28. Mean heart and LAD NTDmean doses for VBH and prone treatments respectively were 0.4 and 0.7 (p


In larger-breasted women, supine VBH provided superior cardiac sparing and reproducibility than a free-breathing prone position.

Wang Helen Yu Chi, Donovan Ellen M, Nisbet Andrew, South Christopher P, Alobaidli Sheaka, Ezhil Veni, Phillips Iain, Prakash Vineet, Ferreira Mark, Webster Philip, Evans Philip M (2019) The stability of imaging biomarkers in radiomics: a framework for evaluation,Physics in Medicine and Biology 64 (16) 165012 pp. 1-12 IOP Publishing
This paper studies the sensitivity of a range of image texture parameters used in radiomics to: i) the number of intensity levels, ii) the method of quantisation to select the intensity levels and iii) the use of an intensity threshold. 43 commonly used texture features were studied for the gross target volume outlined on the CT component of PET/CT scans of 50 patients with non-small cell lung carcinoma (NSCLC). All cases were quantised for all values between 4 and 128 intensity levels using four commonly used quantisation methods. All results were analysed with and without a threshold range of -200 HU to 300 HU. Cases were ranked for each texture feature and for all quantisation methods with the Spearman's rank correlation coefficient determined to evaluate stability. Results showed large fluctuations in ranking, particularly for low numbers of levels, differences between quantisation methods and with the use of a threshold, with values Spearman's Rank Correlation for many parameters below 0.2. Our results demonstrated the sensitivity of radiomics features to the parameters used during analysis and highlight the risk of low reproducibility comparing studies with slightly different parameters. In terms of the lung cancer CT datasets, this study supports the use of 128 intensity levels, the same uniform quantiser applied to all scans and thresholding of the data. It also supports several of the features recommended in the literature for such studies such as skewness and kurtosis. A recommended framework is presented for curation of the data analysis process to ensure stability of results.

Additional publications