Application of automatic sketching of clinical target volume and organs at risk in cervical cancer based on U-net convolutional neural network
LI Xia1 LIU Ya1 WANG Cong2 LI Zhenjiang2#br#
1.Heze Municipal Hospital, Shandong Province, Heze 274000, China;
2.Shandong Cancer Hospital Shandong Institute of Cancer Prevention and Treatment, Shandong Province, Jinan 250012, China
Abstract:Objective To establish the automatic sketching model of clinical target volume (CTV) and organs at risks (OARs) of cervical cancer based on magnetic resonance images using U-net convolutional neural network. Methods A total of 43 patients with stage ⅡB-ⅣA cervical cancer who underwent radical radiotherapy by large aperture magnetic resonance imaging in Shandong Cancer Hospital from April 2019 to December 2020 were enrolled. The tissue structure information of the patient’s magnetic resonance imaging was studied, and the region of interest (ROI) was delineated manually, including CTV and OARs (bladder, rectum, left femoral head, and right femoral head). A total of 43 patients were divided into training set (35 cases), validation set (4 cases) and test set (4 cases) by computer simple random sampling. U-net convolutional neural network was used to construct the training model, and the test set ROI was automatically sketching after verification. The time consumption and Dice similarity coefficient (DSC) value of manual sketching and automatic sketching were compared. Results The average automatic sketching time of patients was (44.5±0.6) s, which was shorter than that of manual sketching (2280.0±356.7) s, and the difference was statistically significant (P < 0.05). The DSC value of automatic and manual sketching: the rectum was (0.752±0.049); CTV was (0.831±0.038); bladder was (0.943±0.016); left femoral head was (0.894±0.009); right femoral head was (0.896±0.004). Conclusion U-net convolutional neural network combined with magnetic resonance images can accurately realize the automatic sketching of CTV and OARs, and improve the practical efficiency of clinical work.
李霞1 刘娅1 王聪2 李振江2. 基于U-net卷积神经网络宫颈癌磁共振临床靶区和危及器官自动勾画的应用[J]. 中国医药导报, 2022, 19(24): 98-102.
LI Xia1 LIU Ya1 WANG Cong2 LI Zhenjiang2. Application of automatic sketching of clinical target volume and organs at risk in cervical cancer based on U-net convolutional neural network. 中国医药导报, 2022, 19(24): 98-102.
[1] Bhatla N,Berek JS,Cuello Fredes M,et al. Revised FIGO staging for carcinoma of the cervix uteri [J]. Int J Gynaecol Obstet,2019,145(1):129-135.
[2] Ahmed M,Schmidt M,Sohaib A,et al. The value of magnetic resonance imaging in target volume delineation of base of tongue tumours--a study using flexible surface coils [J]. Radiother Oncol,2010,94(2):161-167.
[3] Sturdza A,P?觟tter R,Fokdal LU,et al. Image guided brach-ytherapy in locally advanced cervical cancer:Improved pelvic control and survival in RetroEMBRACE,a multicenter cohort study [J]. Radiother Oncol,2016,120(3):428-433.
[4] 周晖,刘昀昀,罗铭,等.《2022 NCCN子宫颈癌临床实践指南(第1版)》解读[J].中国实用妇科与产科杂志,2021, 37(12):1220-1226.
[5] O’Neill BD,Salerno G,Thomas K,et al. MR vs CT imaging:low rectal cancer tumour delineation for three-dimensional conformal radiotherapy [J]. Br J Radiol,2009,82(978):509-513.
[6] Steenbakkers RJ,Deurloo KE,Nowak PJ,et al. Reduction of dose delivered to the rectum and bulb of the penis using MRI delineation for radiotherapy of the prostate [J]. Int J Radiat Oncol Biol Phys,2003,57(5):1269-1279.
[7] P?觟tter R,Dimopoulos J,Georg P,et al. Clinical impact of MRI assisted dose volume adaptation and dose escalation in brachytherapy of locally advanced cervix cancer [J]. Radiother Oncol,2007,83(2):148-155.
[8] Men K,Dai J,Li Y. Automatic segmentation of the clinical target volume and organs at risk in the planning CT for rectal cancer using deep dilated convolutional neural networks [J]. Med Phys,2017,44(12):6377-6389.
[9] Shelhamer E,Long J,Darrell T. Fully convolutional networks for semantic segmentation [J]. IEEE Trans Pattern Anal Mach Intell,2017,39(4):640-651.
[10] Chino J,Annunziata CM,Beriwal S,et al. Radiation Therapy for Cervical Cancer:Executive Summary of an ASTRO Clinical Practice Guideline [J]. Pract Radiat Oncol,2020,10(4):220-234.
[11] Gay HA,Barthold HJ,O’Meara E,et al. Pelvic normal tissue contouring guidelines for radiation therapy:a Radiation Therapy Oncology Group consensus panel atlas [J]. Int J Radiat Oncol Biol Phys,2012,83(3):e353-e362.
[12] Jalaguier-Coudray A,Villard-Mahjoub R,Delouche A,et al. Value of dynamic contrast-enhanced and diffusion-weighted MR imaging in the detection of pathologic complete response in cervical cancer after neoadjuvant therapy:a retrospective observational study [J]. Radiology,2017,284(2):432-442.
[13] Hunt A,Hansen VN,Oelfke U,et al. Adaptive Radiotherapy Enabled by MRI Guidance [J]. Clin Oncol(R Coll Radiol),2018,30(11):711-719.
[14] Kerkhof EM,Raaymakers BW,van der Heide UA,et al. Online MRI guidance for healthy tissue sparing in patients with cervical cancer:an IMRT planning study [J]. Radiother Oncol,2008,88(2):241-249.
[15] Winkel D,Bol GH,Kroon PS,et al. Adaptive radiotherapy:The Elekta Unity MR-linac concept [J]. Clin Transl Radiat Oncol,2019,18:54-59.
[16] Bostel T,Pfaffenberger A,Delorme S,et al. Prospective feasibility analysis of a novel offlfline approach for MR-guided radiotherapy [J]. Strahlenther Onkol,2018,194(5):425-434.
[17] Heijmen B,Voet P,Fransen D,et al. Fully automated,multi-criterial planning for Volumetric Modulated Arc Therapy-An international multicenter validation for prostate cancer [J]. Radiother Oncol,2018,128(2):343-348.
[18] Li N,Zarepisheh M,Uribe-Sanchez A,et al. Automatic treatment plan re-optimization for adaptive radiotherapy guided with the initial plan DVHs [J]. Phys Med Biol,2013,58(24):8725-8738.
[19] 阴晓娟,胡彩容,张秀春,等.基于图谱库的ABAS自动勾画软件在头颈部肿瘤中的可行性研究[J].中华放射肿瘤学杂志,2016,25(11):1233-1237.
[20] Nelms BE,Tomé WA,Robinson G,et al. Variations in the contouring of organs at risk:test case from a patient with oropharyngeal cancer [J]. Int J Radiat Oncol Biol Phys,2012,82(1):368-378.
[21] Li XA,Tai A,Arthur DW,et al. Variability of target and normal structure delineation for breast cancer radiotherapy:an RTOG Multi-Institutional and Multiobserver Study [J]. Int J Radiat Oncol Biol Phys,2009,73(3):944-951.
[22] Chao KS,Bhide S,Chen H,et al. Reduce in variation and improve efficiency of target volume delineation by a computer-assisted system using a deformable image registration approach [J]. Int J Radiat Oncol Biol Phys,2007,68(5):1512-1521.
[23] Fu Y,Mazur TR,Wu X,et al. A novel MRI segmentation method using CNN-based correction network for MRI-guided adaptive radiotherapy [J]. Med Phys,2018,45(11):5129-5137.
[24] Men K,Geng H,Cheng C,et al. Technical Note:More accurate and efficient segmentation of organs-at-risk in radiotherapy with convolutional neural networks cascades [J]. Med Phys,2019,46(1):286-292.
[25] Wang J,Lu JY,QIN G. Technical Note:A deep learning based auto segmentation of rectal tumors in MR images [J]. Med Phys,2018,45(6):2560-2564.
[26] Blanc-Durand P,Van Der Gucht A,Schaefer N,et al. Automatic lesion detection and segmentation of 18F-FET PET in gliomas:a full 3D U-Net convolutional neural network study [J]. PLoS One,2018,13(4):e0195798.
[27] Ronneberger O,Fischer P,Brox T. U-Net:Depthwise convolutional network for biomedical image segmentation [J]. Comput Biol Med,2021,136:104699.