Validation of a Fully Automated Hybrid Deep Learning Cardiac Substructure Segmentation Tool for Contouring and Dose Evaluation in Lung Cancer Radiotherapy.


Journal

Clinical oncology (Royal College of Radiologists (Great Britain))
ISSN: 1433-2981
Titre abrégé: Clin Oncol (R Coll Radiol)
Pays: England
ID NLM: 9002902

Informations de publication

Date de publication:
06 2023
Historique:
received: 05 10 2022
revised: 05 01 2023
accepted: 07 03 2023
medline: 9 5 2023
pubmed: 25 3 2023
entrez: 24 3 2023
Statut: ppublish

Résumé

Accurate and consistent delineation of cardiac substructures is challenging. The aim of this work was to validate a novel segmentation tool for automatic delineation of cardiac structures and subsequent dose evaluation, with potential application in clinical settings and large-scale radiation-related cardiotoxicity studies. A recently developed hybrid method for automatic segmentation of 18 cardiac structures, combining deep learning, multi-atlas mapping and geometric segmentation of small challenging substructures, was independently validated on 30 lung cancer cases. These included anatomical and imaging variations, such as tumour abutting heart, lung collapse and metal artefacts. Automatic segmentations were compared with manual contours of the 18 structures using quantitative metrics, including Dice similarity coefficient (DSC), mean distance to agreement (MDA) and dose comparisons. A comparison of manual and automatic contours across all cases showed a median DSC of 0.75-0.93 and a median MDA of 2.09-3.34 mm for whole heart and chambers. The median MDA for great vessels, coronary arteries, cardiac valves, sinoatrial and atrioventricular conduction nodes was 3.01-8.54 mm. For the 27 cases treated with curative intent (planned target volume dose ≥50 Gy), the median dose difference was -1.12 to 0.57 Gy (absolute difference of 1.13-3.25%) for the mean dose to heart and chambers; and -2.25 to 4.45 Gy (absolute difference of 0.94-6.79%) for the mean dose to substructures. The novel hybrid automatic segmentation tool reported high accuracy and consistency over a validation set with challenging anatomical and imaging variations. This has promising applications in substructure dose calculations of large-scale datasets and for future studies on long-term cardiac toxicity.

Sections du résumé

BACKGROUND AND PURPOSE
Accurate and consistent delineation of cardiac substructures is challenging. The aim of this work was to validate a novel segmentation tool for automatic delineation of cardiac structures and subsequent dose evaluation, with potential application in clinical settings and large-scale radiation-related cardiotoxicity studies.
MATERIALS AND METHODS
A recently developed hybrid method for automatic segmentation of 18 cardiac structures, combining deep learning, multi-atlas mapping and geometric segmentation of small challenging substructures, was independently validated on 30 lung cancer cases. These included anatomical and imaging variations, such as tumour abutting heart, lung collapse and metal artefacts. Automatic segmentations were compared with manual contours of the 18 structures using quantitative metrics, including Dice similarity coefficient (DSC), mean distance to agreement (MDA) and dose comparisons.
RESULTS
A comparison of manual and automatic contours across all cases showed a median DSC of 0.75-0.93 and a median MDA of 2.09-3.34 mm for whole heart and chambers. The median MDA for great vessels, coronary arteries, cardiac valves, sinoatrial and atrioventricular conduction nodes was 3.01-8.54 mm. For the 27 cases treated with curative intent (planned target volume dose ≥50 Gy), the median dose difference was -1.12 to 0.57 Gy (absolute difference of 1.13-3.25%) for the mean dose to heart and chambers; and -2.25 to 4.45 Gy (absolute difference of 0.94-6.79%) for the mean dose to substructures.
CONCLUSION
The novel hybrid automatic segmentation tool reported high accuracy and consistency over a validation set with challenging anatomical and imaging variations. This has promising applications in substructure dose calculations of large-scale datasets and for future studies on long-term cardiac toxicity.

Identifiants

pubmed: 36964031
pii: S0936-6555(23)00112-7
doi: 10.1016/j.clon.2023.03.005
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

370-381

Informations de copyright

Copyright © 2023. Published by Elsevier Ltd.

Auteurs

V Chin (V)

University of New South Wales, South Western Sydney Clinical School, Sydney, Australia; Ingham Institute for Applied Medical Research, Radiation Oncology, Sydney, Australia; Department of Radiation Oncology, Liverpool and Macarthur Cancer Therapy Centres, Sydney, Australia. Electronic address: vicky.chin@unsw.edu.au.

R N Finnegan (RN)

Ingham Institute for Applied Medical Research, Radiation Oncology, Sydney, Australia; School of Physics, Institute of Medical Physics, University of Sydney, Sydney, Australia; Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards, Australia.

P Chlap (P)

University of New South Wales, South Western Sydney Clinical School, Sydney, Australia; Ingham Institute for Applied Medical Research, Radiation Oncology, Sydney, Australia; Department of Radiation Oncology, Liverpool and Macarthur Cancer Therapy Centres, Sydney, Australia.

J Otton (J)

University of New South Wales, South Western Sydney Clinical School, Sydney, Australia; Department of Cardiology, Liverpool Hospital, Sydney, Australia.

A Haidar (A)

University of New South Wales, South Western Sydney Clinical School, Sydney, Australia; Ingham Institute for Applied Medical Research, Radiation Oncology, Sydney, Australia; Department of Radiation Oncology, Liverpool and Macarthur Cancer Therapy Centres, Sydney, Australia.

L Holloway (L)

University of New South Wales, South Western Sydney Clinical School, Sydney, Australia; Ingham Institute for Applied Medical Research, Radiation Oncology, Sydney, Australia; Department of Radiation Oncology, Liverpool and Macarthur Cancer Therapy Centres, Sydney, Australia; School of Physics, Institute of Medical Physics, University of Sydney, Sydney, Australia.

D I Thwaites (DI)

School of Physics, Institute of Medical Physics, University of Sydney, Sydney, Australia; Radiotherapy Research Group, Leeds Institute of Medical Research, St James's Hospital and University of Leeds, Leeds, UK.

J Dowling (J)

University of New South Wales, South Western Sydney Clinical School, Sydney, Australia; School of Physics, Institute of Medical Physics, University of Sydney, Sydney, Australia; CSIRO, Australian e-Health and Research Centre, Herston, Australia.

G P Delaney (GP)

University of New South Wales, South Western Sydney Clinical School, Sydney, Australia; Ingham Institute for Applied Medical Research, Radiation Oncology, Sydney, Australia; Department of Radiation Oncology, Liverpool and Macarthur Cancer Therapy Centres, Sydney, Australia.

S K Vinod (SK)

University of New South Wales, South Western Sydney Clinical School, Sydney, Australia; Ingham Institute for Applied Medical Research, Radiation Oncology, Sydney, Australia; Department of Radiation Oncology, Liverpool and Macarthur Cancer Therapy Centres, Sydney, Australia.

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