论文标题
一个基于深度学习的框架,用于分割无形的临床目标体积,并具有估计的术后前列腺癌放射疗法的不确定性
A deep learning-based framework for segmenting invisible clinical target volumes with estimated uncertainties for post-operative prostate cancer radiotherapy
论文作者
论文摘要
在前列腺癌的术后放疗中,癌性前列腺腺已通过手术去除,因此被照射的临床目标体积(CTV)包含肿瘤细胞的微观散布,这些肿瘤细胞无法在典型的临床图像(例如计算机断层摄影术或磁共振成像中)可视化。在当前的临床实践中,根据临床指南,医生根据与附近器官和其他临床信息的关系手动分段CTV。使用传统图像分割方法自动化术后前列腺CTV分割是一个重大挑战。在这里,我们提出了一个深度学习模型,以通过首先将附近器官分割,然后使用与CTV的关系来协助CTV分割来克服此问题。提出的模型是使用临床批准和用于患者治疗的标签进行培训的,由于缺乏视觉地面真相,该标签会经过相对较大的疗程间变化。该模型的平均骰子相似性系数(DSC)在50名患者的保留数据集上为0.87,比建立的方法(例如基于ATLAS的方法)(DSC <0.7)要好得多。估计与自动分割的CTV轮廓相关的不确定性也有助于医生检查和修改轮廓,尤其是在具有较大的跨物理学变量的区域。我们还使用4点分级系统来表明自动分割的CTV轮廓的临床质量等于医生手动绘制的批准临床轮廓的临床质量。
In post-operative radiotherapy for prostate cancer, the cancerous prostate gland has been surgically removed, so the clinical target volume (CTV) to be irradiated encompasses the microscopic spread of tumor cells, which cannot be visualized in typical clinical images such as computed tomography or magnetic resonance imaging. In current clinical practice, physicians segment CTVs manually based on their relationship with nearby organs and other clinical information, per clinical guidelines. Automating post-operative prostate CTV segmentation with traditional image segmentation methods has been a major challenge. Here, we propose a deep learning model to overcome this problem by segmenting nearby organs first, then using their relationship with the CTV to assist CTV segmentation. The model proposed is trained using labels clinically approved and used for patient treatment, which are subject to relatively large inter-physician variations due to the absence of a visual ground truth. The model achieves an average Dice similarity coefficient (DSC) of 0.87 on a holdout dataset of 50 patients, much better than established methods, such as atlas-based methods (DSC<0.7). The uncertainties associated with automatically segmented CTV contours are also estimated to help physicians inspect and revise the contours, especially in areas with large inter-physician variations. We also use a 4-point grading system to show that the clinical quality of the automatically segmented CTV contours is equal to that of approved clinical contours manually drawn by physicians.