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Assessment of accuracy and efficiency of atlas-based autosegmentation for prostate radiotherapy in a variety of clinical conditions

Prüfung von Genauigkeit und Effizienz atlasbasierter Konturierung zur Strahlentherapie des Prostatakarzinoms bei verschiedenen klinischen Gegebenheiten

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Abstract

Background and purpose

The goal of the current study was to evaluate the commercially available atlas-based autosegmentation software for clinical use in prostate radiotherapy. The accuracy was benchmarked against interobserver variability.

Material and methods

A total of 20 planning computed tomographs (CTs) and 10 cone-beam CTs (CBCTs) were selected for prostate, rectum, and bladder delineation. The images varied regarding to individual (age, body mass index) and setup parameters (contrast agent, rectal balloon, implanted markers). Automatically created contours with ABAS® and iPlan® were compared to an expert’s delineation by calculating the Dice similarity coefficient (DSC) and conformity index.

Results

Demo-atlases of both systems showed different results for bladder (DSCABAS 0.86 ± 0.17, DSCiPlan 0.51 ± 0.30) and prostate (DSCABAS 0.71 ± 0.14, DSCiPlan 0.57 ± 0.19). Rectum delineation (DSCABAS 0.78 ± 0.11, DSCiPlan 0.84 ± 0.08) demonstrated differences between the systems but better correlation of the automatically drawn volumes. ABAS® was closest to the interobserver benchmark. Autosegmentation with iPlan®, ABAS® and manual segmentation took 0.5, 4 and 15–20 min, respectively. Automatic contouring on CBCT showed high dependence on image quality (DSC bladder 0.54, rectum 0.42, prostate 0.34).

Conclusion

For clinical routine, efforts are still necessary to either redesign algorithms implemented in autosegmentation or to optimize image quality for CBCT to guarantee required accuracy and time savings for adaptive radiotherapy.

Zusammenfassung

Hintergrund und Ziel

Zwei kommerziell erhältliche Systeme zur atlasbasierten automatischen Konturierung wurden hinsichtlich Genauigkeit mit der Interobservervariabilität bei Prostatakarzinomen verglichen.

Material und Methoden

Insgesamt wurden 20 Planungs-CTs und 10 CBCTs (cone-beam CTs) zur Konturierung von Prostata, Rektum und Blase herangezogen. Die Bilddaten variierten hinsichtlich patientenspezifischer (Alter, Body Mass Index) und planungsspezifischer Parameter (Kontrastmittel, Rektumballon, Goldmarker). Automatisch generierte Konturen von ABAS® und iPlan® wurden mit der manuellen Konturierung eines Experten mit Hilfe des „Dice-similarity“-Koeffizienten (DSC) und dem Konformitätsindex verglichen.

Ergebnisse

Die Demoatlanten beider Systeme zeigten unterschiedliche Ergebnisse für Blase (DSCABAS 0,86 ± 0,17; DSCiPlan 0,51 ± 0,30) und Prostata (DSCABAS 0,71 ± 0,14; DSCiPlan 0,57 ± 0,19). Bei den Rektumkonturen (DSCABAS 0,78 ± 0,11; DSCiPlan 0,84 ± 0,08) zeigten sich zwar auch Unterschiede, aber mit einer größeren Korrelation der automatisch erzeugten Volumen. ABAS® wies eine bessere Übereinstimmung zur Interobservervariabilität auf. Die benötigte Zeit für die automatische Konturierung mit iPlan®, ABAS® bzw. manueller Konturierung betrug jeweils 0,5 min, 4 min und 15–20 min. Automatische Konturierungen an CBCTs waren sehr stark abhängig von der Bildqualität (DSC Blase 0,54, Rektum 0,42, Prostata 0,34).

Schlussfolgerung

Für den Einsatz der Systeme in der klinischen Routine sind weitere Bestrebungen zur Verbesserung der Algorithmen als auch zur Bildqualitätsverbesserung am CBCT notwendig. Erst dadurch können die notwendige Genauigkeit und Einsparungen in der Zeit für die adaptierte Strahlentherapie erreicht werden.

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Acknowledgment

This work was supported by the Austrian Science Foundation FWF under project L503.

Conflict of interest

On behalf of all authors, the corresponding author states that there are no conflicts of interest.

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Authors and Affiliations

  1. Division of Medical Radiation Physics, Department of Radiation Oncology, Medical University Vienna/AKH Vienna, Währinger Gürtel 18–20, 1090, Vienna, Austria

    I. Simmat, P. Georg, D. Georg, G. Goldner & M. Stock

  2. Center for Medical Physics and Biomedical Engineering, Medical University Vienna, Vienna, Austria

    W. Birkfellner

  3. Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University Vienna, Vienna, Austria

    P. Georg, D. Georg, W. Birkfellner, G. Goldner & M. Stock

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  1. I. Simmat
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  2. P. Georg
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  4. W. Birkfellner
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  5. G. Goldner
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  6. M. Stock
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Correspondence to M. Stock.

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Simmat, I., Georg, P., Georg, D. et al. Assessment of accuracy and efficiency of atlas-based autosegmentation for prostate radiotherapy in a variety of clinical conditions. Strahlenther Onkol 188, 807–815 (2012). https://doi.org/10.1007/s00066-012-0117-0

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