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Validation of clinical acceptability of an atlas-based segmentation algorithm for the delineation of organs at risk in head and neck cancer

Hoang Duc, AK; Eminowicz, G; Mendes, R; Wong, SL; McClelland, J; Modat, M; Cardoso, MJ; ... Ourselin, S; + view all (2015) Validation of clinical acceptability of an atlas-based segmentation algorithm for the delineation of organs at risk in head and neck cancer. Medical Physics , 42 (9) pp. 5027-5034. 10.1118/1.4927567. Green open access

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Abstract

PURPOSE: The aim of this study was to assess whether clinically acceptable segmentations of organs at risk (OARs) in head and neck cancer can be obtained automatically and efficiently using the novel "similarity and truth estimation for propagated segmentations" (STEPS) compared to the traditional "simultaneous truth and performance level estimation" (STAPLE) algorithm. METHODS: First, 6 OARs were contoured by 2 radiation oncologists in a dataset of 100 patients with head and neck cancer on planning computed tomography images. Each image in the dataset was then automatically segmented with STAPLE and STEPS using those manual contours. Dice similarity coefficient (DSC) was then used to compare the accuracy of these automatic methods. Second, in a blind experiment, three separate and distinct trained physicians graded manual and automatic segmentations into one of the following three grades: clinically acceptable as determined by universal delineation guidelines (grade A), reasonably acceptable for clinical practice upon manual editing (grade B), and not acceptable (grade C). Finally, STEPS segmentations graded B were selected and one of the physicians manually edited them to grade A. Editing time was recorded. RESULTS: Significant improvements in DSC can be seen when using the STEPS algorithm on large structures such as the brainstem, spinal canal, and left/right parotid compared to the STAPLE algorithm (all p < 0.001). In addition, across all three trained physicians, manual and STEPS segmentation grades were not significantly different for the brainstem, spinal canal, parotid (right/left), and optic chiasm (all p > 0.100). In contrast, STEPS segmentation grades were lower for the eyes (p < 0.001). Across all OARs and all physicians, STEPS produced segmentations graded as well as manual contouring at a rate of 83%, giving a lower bound on this rate of 80% with 95% confidence. Reduction in manual interaction time was on average 61% and 93% when automatic segmentations did and did not, respectively, require manual editing. CONCLUSIONS: The STEPS algorithm showed better performance than the STAPLE algorithm in segmenting OARs for radiotherapy of the head and neck. It can automatically produce clinically acceptable segmentation of OARs, with results as relevant as manual contouring for the brainstem, spinal canal, the parotids (left/right), and optic chiasm. A substantial reduction in manual labor was achieved when using STEPS even when manual editing was necessary.

Type: Article
Title: Validation of clinical acceptability of an atlas-based segmentation algorithm for the delineation of organs at risk in head and neck cancer
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1118/1.4927567
Publisher version: http://dx.doi.org/10.1118/1.4927567
Additional information: © 2015 American Association of Physicists in Medicine. All article content, except where otherwise noted, is licensed under a Creative Commons Attribution 3.0 Unported License.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Med Phys and Biomedical Eng
URI: https://discovery.ucl.ac.uk/id/eprint/1475535
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