Application of an automatic segmentation method for evaluating cardiac structure doses received by breast radiotherapy patients.
Ontology highlight
ABSTRACT: Background and purpose
Quantifying radiation dose to cardiac substructures is important for research on the etiology and prevention of complications following radiotherapy; however, segmentation of substructures is challenging. In this study we demonstrate the application of our atlas-based automatic segmentation method to breast cancer radiotherapy plans for generating radiation doses in support of late effects research.Material and methods
We applied our segmentation method to contour heart substructures on the computed tomography (CT) images of 70 breast cancer patients who received external photon radiotherapy. Two cardiologists provided manual segmentation of the whole heart (WH), left/right atria, left/right ventricles, and left anterior descending artery (LAD). The automatically contours were compared with manual delineations to evaluate similarity in terms of geometry and dose.Results
The mean Dice similarity coefficient between manual and automatic segmentations was 0.96 for the WH, 0.65 to 0.82 for the atria and ventricles, and 0.06 for the LAD. The mean average surface distance was 1.2 mm for the WH, 3.4 to 4.1 mm for the atria and ventricles, and 6.4 mm for the LAD. We found the dose to the cardiac substructures based on our automatic segmentation agrees with manual segmentation within expected observer variability. For left breast patients, the mean absolute difference in mean dose was 0.1 Gy for the WH, 0.2 to 0.7 Gy for the atria and ventricles, and 1.8 Gy for the LAD. For right breast patients, these values were 0.0 Gy, 0.1 to 0.4 Gy, and 0.4 Gy, respectively.Conclusion
Our automatic segmentation method will facilitate the development of radiotherapy prescriptive criteria for mitigating cardiovascular complications.
SUBMITTER: Jung JW
PROVIDER: S-EPMC8397890 | biostudies-literature |
REPOSITORIES: biostudies-literature
Similar Datasets
Project description:Background and purposeWe developed an automatic method to segment cardiac substructures given a radiotherapy planning CT images to support epidemiological studies or clinical trials looking at cardiac disease endpoints after radiotherapy.Material and methodsWe used a most-similar atlas selection algorithm and 3D deformation combined with 30 detailed cardiac atlases. We cross-validated our method within the atlas library by evaluating geometric comparison metrics and by comparing cardiac doses for simulated breast radiotherapy between manual and automatic contours. We analyzed the impact of the number of cardiac atlas in the library and the use of manual guide points on the performance of our method.ResultsThe Dice Similarity Coefficients from the cross-validation reached up to 97% (whole heart) and 80% (chambers). The Average Surface Distance for the coronary arteries was less than 10.3 mm on average, with the best agreement (7.3 mm) in the left anterior descending artery (LAD). The dose comparison for simulated breast radiotherapy showed differences less than 0.06 Gy for the whole heart and atria, and 0.3 Gy for the ventricles. For the coronary arteries, the dose differences were 2.3 Gy (LAD) and 0.3 Gy (other arteries). The sensitivity analysis showed no notable improvement beyond ten atlases and the manual guide points does not significantly improve performance.ConclusionWe developed an automated method to contour cardiac substructures for radiotherapy CTs. When combined with accurate dose calculation techniques, our method should be useful for cardiac dose reconstruction of a large number of patients in epidemiological studies or clinical trials.
| S-EPMC7807574 | biostudies-literature
Project description:Purpose: More and more automatic segmentation tools are being introduced in routine clinical practice. However, physicians need to spend a considerable amount of time in examining the generated contours slice by slice. This greatly reduces the benefit of the tool's automaticity. In order to overcome this shortcoming, we developed an automatic quality assurance (QA) method for automatic segmentation using convolutional neural networks (CNNs). Materials and Methods: The study cohort comprised 680 patients with early-stage breast cancer who received whole breast radiation. The overall architecture of the automatic QA method for deep learning-based segmentation included the following two main parts: a segmentation CNN model and a QA network that was established based on ResNet-101. The inputs were from computed tomography, segmentation probability maps, and uncertainty maps. Two kinds of Dice similarity coefficient (DSC) outputs were tested. One predicted the DSC quality level of each slice ([0.95, 1] for "good," [0.8, 0.95] for "medium," and [0, 0.8] for "bad" quality), and the other predicted the DSC value of each slice directly. The performances of the method to predict the quality levels were evaluated with quantitative metrics: balanced accuracy, F score, and the area under the receiving operator characteristic curve (AUC). The mean absolute error (MAE) was used to evaluate the DSC value outputs. Results: The proposed methods involved two types of output, both of which achieved promising accuracy in terms of predicting the quality level. For the good, medium, and bad quality level prediction, the balanced accuracy was 0.97, 0.94, and 0.89, respectively; the F score was 0.98, 0.91, and 0.81, respectively; and the AUC was 0.96, 0.93, and 0.88, respectively. For the DSC value prediction, the MAE was 0.06 ± 0.19. The prediction time was approximately 2 s per patient. Conclusions: Our method could predict the segmentation quality automatically. It can provide useful information for physicians regarding further verification and revision of automatic contours. The integration of our method into current automatic segmentation pipelines can improve the efficiency of radiotherapy contouring.
| S-EPMC7212344 | biostudies-literature
Project description:PURPOSE:To develop and validate a set of atlases for auto-contouring cardiac substructures. METHODS:Eight radiation oncologists manually and independently delineated 15 cardiac substructures from noncontrast CT images of 6 patients by referring to their respective fused contrast CT images. Individual contours were fused together for each structure, edited by 2 physicians, and became atlases to delineate other 6 patients. The auto-delineated contours of the 6 additional patients became templates for manual contouring. These 12 patients with well-defined contours composed the final atlases for multi-atlas segmentation. RESULTS:The average time for manually contouring the 15 cardiac substructures was about 40min. Inter-observer variability was small for the heart, the chambers, and the aorta compared with that for other structures that were not clearly distinguishable in CT images. The mean dice similarity coefficient and mean surface distance of auto-segmented contours were within one standard deviation of expert contouring variability. Good agreement between auto-segmented and manual contours was observed for the heart, the chambers, and the great vessels. Independent validation on other 19 patients showed reasonable agreement for the heart chambers. CONCLUSIONS:A set of cardiac atlases was created for auto-contouring from noncontrast CT images. The accuracy of auto-contouring for the heart, chambers, and great vessels was validated for potential clinical use.
| S-EPMC5292289 | biostudies-literature
Project description:ObjectiveThe objective is to present a proof-of-concept of a semi-automatic method to reduce hippocampus segmentation time on magnetic resonance images (MRI).Materials and methodsFAst Segmentation Through SURface Fairing (FASTSURF) is based on a surface fairing technique which reconstructs the hippocampus from sparse delineations. To validate FASTSURF, simulations were performed in which sparse delineations extracted from full manual segmentations served as input. On three different datasets with different diagnostic groups, FASTSURF hippocampi were compared to the original segmentations using Jaccard overlap indices and percentage volume differences (PVD). In one data set for which back-to-back scans were available, unbiased estimates of overlap and PVD were obtained. Using longitudinal scans, we compared hippocampal atrophy rates measured by manual, FASTSURF and two automatic segmentations (FreeSurfer and FSL-FIRST).ResultsWith only seven input contours, FASTSURF yielded mean Jaccard indices ranging from 72(±4.3)% to 83(±2.6)% and PVDs ranging from 0.02(±2.40)% to 3.2(±3.40)% across the three datasets. Slightly poorer results were obtained for the unbiased analysis, but the performance was still considerably better than both tested automatic methods with only five contours.ConclusionsFASTSURF segmentations have high accuracy and require only a fraction of the delineation effort of fully manual segmentation. Atrophy rate quantification based on completely manual segmentation is well reproduced by FASTSURF. Therefore, FASTSURF is a promising tool to be implemented in clinical workflow, provided a future prospective validation confirms our findings.
| S-EPMC6338359 | biostudies-literature
Project description:PURPOSE:Segmentation of cardiac medical images, an important step in measuring cardiac function, is usually performed either manually or semiautomatically. Fully automatic segmentation of the left ventricle (LV), the right ventricle (RV) as well as the myocardium of three-dimensional (3D) magnetic resonance (MR) images throughout the entire cardiac cycle (four-dimensional, 4D), remains challenging. This study proposes a deformable-based segmentation methodology for efficiently segmenting 4D (3D + t) cardiac MR images. METHODS:The proposed methodology first used the Hough transform and the local Gaussian distribution method (LGD) to segment the LV endocardial contours from cardiac MR images. Following this, a novel level set-based shape prior method was applied to generate the LV epicardial contours and the RV boundary. RESULTS:This automatic image segmentation approach has been applied to studies on 17 subjects. The results demonstrated that the proposed method was efficient compared to manual segmentation, achieving a segmentation accuracy with average Dice values of 88.62 ± 5.47%, 87.35 ± 7.26%, and 82.63 ± 6.22% for the LV endocardial, LV epicardial, and RV contours, respectively. CONCLUSIONS:We have presented a method for accurate LV and RV segmentation. Compared to three existing methods, the proposed method can successfully segment the LV and yield the highest Dice value. This makes it an option for clinical assessment of the volume, size, and thickness of the ventricles.
| S-EPMC6322927 | biostudies-literature
Project description:In recent years, many automatic brain structure segmentation methods have been proposed. However, these methods are commonly tested with non-lesioned brains and the effect of lesions on their performance has not been evaluated. Here, we analyze the effect of multiple sclerosis (MS) lesions on three well-known automatic brain structure segmentation methods, namely, FreeSurfer, FIRST and multi-atlas fused by majority voting, which use learning-based, deformable and atlas-based strategies, respectively. To perform a quantitative analysis, 100 synthetic images of MS patients with a total of 2174 lesions are simulated on two public databases with available brain structure ground truth information (IBSR18 and MICCAI'12). The Dice similarity coefficient (DSC) differences and the volume differences between the healthy and the simulated images are calculated for the subcortical structures and the brainstem. We observe that the three strategies are affected when lesions are present. However, the effects of the lesions do not follow the same pattern; the lesions either make the segmentation method underperform or surprisingly augment the segmentation accuracy. The obtained results show that FreeSurfer is the method most affected by the presence of lesions, with DSC differences (generated - healthy) ranging from - 0.11 ± 0.54 to 9.65 ± 9.87, whereas FIRST tends to be the most robust method when lesions are present (- 2.40 ± 5.54 to 0.44 ± 0.94). Lesion location is not important for global strategies such as FreeSurfer or majority voting, where structure segmentation is affected wherever the lesions exist. On the other hand, FIRST is more affected when the lesions are overlaid or close to the structure of analysis. The most affected structure by the presence of lesions is the nucleus accumbens (from - 1.12 ± 2.53 to 1.32 ± 4.00 for the left hemisphere and from - 2.40 ± 5.54 to 9.65 ± 9.87 for the right hemisphere), whereas the structures that show less variation include the thalamus (from 0.03 ± 0.35 to 0.74 ± 0.89 and from - 0.48 ± 1.08 to - 0.04 ± 0.22) and the brainstem (from - 0.20 ± 0.38 to 1.03 ± 1.31). The three segmentation approaches are affected by the presence of MS lesions, which demonstrates that there exists a problem in the automatic segmentation methods of the deep gray matter (DGM) structures that has to be taken into account when using them as a tool to measure the disease progression.
| S-EPMC5430150 | biostudies-literature
Project description:Purpose: To evaluate the accuracy of deep-learning-based auto-segmentation of the superior constrictor, middle constrictor, inferior constrictor, and larynx in comparison with a traditional multi-atlas-based method. Methods and Materials: One hundred and five computed tomography image datasets from 83 head and neck cancer patients were retrospectively collected and the superior constrictor, middle constrictor, inferior constrictor, and larynx were analyzed for deep-learning versus multi-atlas-based segmentation. Eighty-three computed tomography images (40 diagnostic computed tomography and 43 planning computed tomography) were used for training the convolutional neural network, and for atlas-based model training. The remaining 22 computed tomography datasets were used for validation of the atlas-based auto-segmentation versus deep-learning-based auto-segmentation contours, both of which were compared with the corresponding manual contours. Quantitative measures included Dice similarity coefficient, recall, precision, Hausdorff distance, 95th percentile of Hausdorff distance, and mean surface distance. Dosimetric differences between the auto-generated contours and manual contours were evaluated. Subjective evaluation was obtained from 3 clinical observers to blindly score the autosegmented structures based on the percentage of slices that require manual modification. Results: The deep-learning-based auto-segmentation versus atlas-based auto-segmentation results were compared for the superior constrictor, middle constrictor, inferior constrictor, and larynx. The mean Dice similarity coefficient values for the 4 structures were 0.67, 0.60, 0.65, and 0.84 for deep-learning-based auto-segmentation, whereas atlas-based auto-segmentation has Dice similarity coefficient results at 0.45, 0.36, 0.50, and 0.70, respectively. The mean 95th percentile of Hausdorff distance (cm) for the 4 structures were 0.41, 0.57, 0.59, and 0.54 for deep-learning-based auto-segmentation, but 0.78, 0.95, 0.96, and 1.23 for atlas-based auto-segmentation results, respectively. Similar mean dose differences were obtained from the 2 sets of autosegmented contours compared to manual contours. The dose-volume discrepancies and the average modification rates were higher with the atlas-based auto-segmentation contours. Conclusion: Swallowing-related structures are more accurately generated with DL-based versus atlas-based segmentation when compared with manual contours.
| S-EPMC9340321 | biostudies-literature
Project description:The purpose of this study was to determine whether a deep-learning-based assessment system could facilitate preoperative grading of meningioma. This was a retrospective study conducted at two institutions covering 643 patients. The system, designed with a cascade network structure, was developed using deep-learning technology for automatic tumor detection, visual assessment, and grading prediction. Specifically, a modified U-Net convolutional neural network was first established to segment tumor images. Subsequently, the segmentations were introduced into rendering algorithms for spatial reconstruction and another DenseNet convolutional neural network for grading prediction. The trained models were integrated as a system, and the robustness was tested based on its performance on an external dataset from the second institution involving different magnetic resonance imaging platforms. The results showed that the segment model represented a noteworthy performance with dice coefficients of 0.920 ± 0.009 in the validation group. With accurate segmented tumor images, the rendering model delicately reconstructed the tumor body and clearly displayed the important intracranial vessels. The DenseNet model also achieved high accuracy with an area under the curve of 0.918 ± 0.006 and accuracy of 0.901 ± 0.039 when classifying tumors into low-grade and high-grade meningiomas. Moreover, the system exhibited good performance on the external validation dataset.
| S-EPMC8401675 | biostudies-literature
Project description:Nanobubbles (NBs) on hydrophobic surfaces in aqueous solvents have shown great potential in numerous applications. In this study, the morphological characterization of NBs in AFM images was carried out with the assistance of a novel image segmentation method. The method combines the classical threshold method and a modified, active contour method to achieve optimized image segmentation. The image segmentation results obtained with the classical threshold method and the proposed, modified method were compared. With the modified method, the diameter, contact angle, and radius of curvature were automatically measured for all NBs in AFM images. The influence of the selection of the threshold value on the segmentation result was discussed. Moreover, the morphological change in the NBs was studied in terms of density, covered area, and volume occurring during coalescence under external disturbance.
| S-EPMC4419579 | biostudies-literature
Project description:Atlas-based autosegmentation is an established tool for segmenting structures for CT-planned head and neck radiotherapy. MRI is being increasingly integrated into the planning process. The aim of this study is to assess the feasibility of MRI-based, atlas-based autosegmentation for organs at risk (OAR) and lymph node levels, and to compare the segmentation accuracy with CT-based autosegmentation. Fourteen patients with locally advanced head and neck cancer in a prospective imaging study underwent a T1-weighted MRI and a PET-CT (with dedicated contrast-enhanced CT) in an immobilization mask. Organs at risk (orbits, parotids, brainstem, and spinal cord) and the left level II lymph node region were manually delineated on the CT and MRI separately. A 'leave one out' approach was used to automatically segment structures onto the remaining images separately for CT and MRI. Contour comparison was performed using multiple positional metrics: Dice index, mean distance to conformity (MDC), sensitivity index (Se Idx), and inclusion index (Incl Idx). Automatic segmentation using MRI of orbits, parotids, brainstem, and lymph node level was acceptable with a DICE coefficient of 0.73-0.91, MDC 2.0-5.1mm, Se Idx 0.64-0.93, Incl Idx 0.76-0.93. Segmentation of the spinal cord was poor (Dice coefficient 0.37). The process of automatic segmentation was significantly better on MRI compared to CT for orbits, parotid glands, brainstem, and left lymph node level II by multiple positional metrics; spinal cord segmentation based on MRI was inferior compared with CT. Accurate atlas-based automatic segmentation of OAR and lymph node levels is feasible using T1-MRI; segmentation of the spinal cord was found to be poor. Comparison with CT-based automatic segmentation suggests that the process is equally as, or more accurate, using MRI. These results support further translation of MRI-based segmentation methodology into clinicalpractice.
| S-EPMC5690045 | biostudies-literature