Dataset Information

Dynamic multiatlas selection-based consensus segmentation of head and neck structures from CT images.

ABSTRACT: PURPOSE:Manual delineation of head and neck (H&N) organ-at-risk (OAR) structures for radiation therapy planning is time consuming and highly variable. Therefore, we developed a dynamic multiatlas selection-based approach for fast and reproducible segmentation. METHODS:Our approach dynamically selects and weights the appropriate number of atlases for weighted label fusion and generates segmentations and consensus maps indicating voxel-wise agreement between different atlases. Atlases were selected for a target as those exceeding an alignment weight called dynamic atlas attention index. Alignment weights were computed at the image level and called global weighted voting (GWV) or at the structure level and called structure weighted voting (SWV) by using a normalized metric computed as the sum of squared distances of computed tomography (CT)-radiodensity and modality-independent neighborhood descriptors (extracting edge information). Performance comparisons were performed using 77 H&N CT images from an internal Memorial Sloan-Kettering Cancer Center dataset (N = 45) and an external dataset (N = 32) using Dice similarity coefficient (DSC), Hausdorff distance (HD), 95th percentile of HD, median of maximum surface distance, and volume ratio error against expert delineation. Pairwise DSC accuracy comparisons of proposed (GWV, SWV) vs single best atlas (BA) or majority voting (MV) methods were performed using Wilcoxon rank-sum tests. RESULTS:Both SWV and GWV methods produced significantly better segmentation accuracy than BA (P < 0.001) and MV (P < 0.001) for all OARs within both datasets. SWV generated the most accurate segmentations with DSC of: 0.88 for oral cavity, 0.85 for mandible, 0.84 for cord, 0.76 for brainstem and parotids, 0.71 for larynx, and 0.60 for submandibular glands. SWV's accuracy exceeded GWV's for submandibular glands (DSC = 0.60 vs 0.52, P = 0.019). CONCLUSIONS:The contributed SWV and GWV methods generated more accurate automated segmentations than the other two multiatlas-based segmentation techniques. The consensus maps could be combined with segmentations to visualize voxel-wise consensus between atlases within OARs during manual review.

SUBMITTER: Haq R

PROVIDER: S-EPMC7042892 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Dynamic multiatlas selection-based consensus segmentation of head and neck structures from CT images.

Haq Rabia R Berry Sean L SL Deasy Joseph O JO Hunt Margie M Veeraraghavan Harini H

Medical physics 20191031 12

<h4>Purpose</h4>Manual delineation of head and neck (H&N) organ-at-risk (OAR) structures for radiation therapy planning is time consuming and highly variable. Therefore, we developed a dynamic multiatlas selection-based approach for fast and reproducible segmentation.<h4>Methods</h4>Our approach dynamically selects and weights the appropriate number of atlases for weighted label fusion and generates segmentations and consensus maps indicating voxel-wise agreement between different atlases. Atlas ...[more]

PMID: 31587300

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Project description:Owing to its excellent soft-tissue contrast, magnetic resonance (MR) imaging has found an increased application in radiation therapy (RT). By harnessing these properties for treatment planning, automated segmentation methods can alleviate the manual workload burden to the clinical workflow. We investigated atlas-based segmentation methods of organs at risk (OARs) in the head and neck (H&N) region using one approach that selected the most similar atlas from a library of segmented images and two multi-atlas approaches. The latter were based on weighted majority voting and an iterative atlas-fusion approach called STEPS. We built the atlas library from pre-treatment T1-weighted MR images of 12 patients with manual contours of the parotids, spinal cord and mandible, delineated by a clinician. Following a leave-one-out cross-validation strategy, we measured the geometric accuracy by calculating Dice similarity coefficients (DSC), standard and 95% Hausdorff distances (HD and HD95), and the mean surface distance (MSD), whereby the manual contours served as the gold standard. To benchmark the algorithm, we determined the inter-observer variability (IOV) between three observers. To investigate the dosimetric effect of segmentation inaccuracies, we implemented an auto-planning strategy within the treatment planning system Monaco (Elekta AB, Stockholm, Sweden). For each set of auto-segmented OARs, we generated a plan for a 9-beam step and shoot intensity modulated RT treatment, designed according to our institution's clinical H&N protocol. Superimposing the dose distributions on the gold standard OARs, we calculated dose differences to OARs caused by delineation differences between auto-segmented and gold standard OARs. We investigated the correlations between geometric and dosimetric differences. The mean DSC was larger than 0.8 and the mean MSD smaller than 2?mm for the multi-atlas approaches, resulting in a geometric accuracy comparable to previously published results and within the range of the IOV. While dosimetric differences could be as large as 23% of the clinical goal, treatment plans fulfilled all imposed clinical goals for the gold standard OARs. Correlations between geometric and dosimetric measures were low with R2??<??0.5. The geometric accuracy and the ability to achieve clinically acceptable treatment plans indicate the suitability of using atlas-based contours for RT treatment planning purposes. The low correlations between geometric and dosimetric measures suggest that geometric measures alone are not sufficient to predict the dosimetric impact of segmentation inaccuracies on treatment planning for the data utilised in this study.

Project description:Accurate delineation of organs at risk (OARs) is a precondition for intensity modulated radiation therapy. However, manual delineation of OARs is time consuming and prone to high interobserver variability. Because of image artifacts and low image contrast between different structures, however, the number of available approaches for autosegmentation of structures in the head-neck area is still rather low. In this project, a new approach for automated segmentation of head-neck CT images that combine the robustness of multiatlas-based segmentation with the flexibility of geodesic active contours and the prior knowledge provided by statistical appearance models is presented.The presented approach is using an atlas-based segmentation approach in combination with label fusion in order to initialize a segmentation pipeline that is based on using statistical appearance models and geodesic active contours. An anatomically correct approximation of the segmentation result provided by atlas-based segmentation acts as a starting point for an iterative refinement of this approximation. The final segmentation result is based on using model to image registration and geodesic active contours, which are mutually influencing each other.18 CT images in combination with manually segmented labels of parotid glands and brainstem were used in a leave-one-out cross validation scheme in order to evaluate the presented approach. For this purpose, 50 different statistical appearance models have been created and used for segmentation. Dice coefficient (DC), mean absolute distance and max. Hausdorff distance between the autosegmentation results and expert segmentations were calculated. An average Dice coefficient of DC = 0.81 (right parotid gland), DC = 0.84 (left parotid gland), and DC = 0.86 (brainstem) could be achieved.The presented framework provides accurate segmentation results for three important structures in the head neck area. Compared to a segmentation approach based on using multiple atlases in combination with label fusion, the proposed hybrid approach provided more accurate results within a clinically acceptable amount of time.

Project description:Transcranial brain stimulation (TBS) has been established as a method for modulating and mapping the function of the human brain, and as a potential treatment tool in several brain disorders. Typically, the stimulation is applied using a one-size-fits-all approach with predetermined locations for the electrodes, in electric stimulation (TES), or the coil, in magnetic stimulation (TMS), which disregards anatomical variability between individuals. However, the induced electric field distribution in the head largely depends on anatomical features implying the need for individually tailored stimulation protocols for focal dosing. This requires detailed models of the individual head anatomy, combined with electric field simulations, to find an optimal stimulation protocol for a given cortical target. Considering the anatomical and functional complexity of different brain disorders and pathologies, it is crucial to account for the anatomical variability in order to translate TBS from a research tool into a viable option for treatment. In this article we present a new method, called CHARM, for automated segmentation of fifteen different head tissues from magnetic resonance (MR) scans. The new method compares favorably to two freely available software tools on a five-tissue segmentation task, while obtaining reasonable segmentation accuracy over all fifteen tissues. The method automatically adapts to variability in the input scans and can thus be directly applied to clinical or research scans acquired with different scanners, sequences or settings. We show that an increase in automated segmentation accuracy results in a lower relative error in electric field simulations when compared to anatomical head models constructed from reference segmentations. However, also the improved segmentations and, by implication, the electric field simulations are affected by systematic artifacts in the input MR scans. As long as the artifacts are unaccounted for, this can lead to local simulation differences up to 30% of the peak field strength on reference simulations. Finally, we exemplarily demonstrate the effect of including all fifteen tissue classes in the field simulations against the standard approach of using only five tissue classes and show that for specific stimulation configurations the local differences can reach 10% of the peak field strength.

Dataset Information

Dynamic multiatlas selection-based consensus segmentation of head and neck structures from CT images.

Publications

Dynamic multiatlas selection-based consensus segmentation of head and neck structures from CT images.

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