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Publication

Publication

Clinical Feasibility of Deep Learning-Based Auto-Segmentation of Target Volumes and Organs-at-Risk in Breast Cancer Patients
Journal
Radiation Oncology
Vol
16
Page
Article number: 44
Author
Seung Yeun Chung, Jee Suk Chang, Min Seo Choi, Yongjin Chang, Byong Su Choi, Jaehee Chun, Ki Chang Keum, Jin Sung Kim & Yong Bae Kim
Year
AI-powered treatment planning
Date
Feb, 2021
File
13014_2021_Article_1771.pdf (1.8M) 2회 다운로드 DATE : 2021-03-15 16:32:00
Background
In breast cancer patients receiving radiotherapy (RT), accurate target delineation and reduction of radiation doses to the nearby normal organs is important. However, manual clinical target volume (CTV) and organs-at-risk (OARs) segmentation for treatment planning increases physicians’ workload and inter-physician variability considerably. In this study, we evaluated the potential benefits of deep learning-based auto-segmented contours by comparing them to manually delineated contours for breast cancer patients.

Methods
CTVs for bilateral breasts, regional lymph nodes, and OARs (including the heart, lungs, esophagus, spinal cord, and thyroid) were manually delineated on planning computed tomography scans of 111 breast cancer patients who received breast-conserving surgery. Subsequently, a two-stage convolutional neural network algorithm was used. Quantitative metrics, including the Dice similarity coefficient (DSC) and 95% Hausdorff distance, and qualitative scoring by two panels from 10 institutions were used for analysis. Inter-observer variability and delineation time were assessed; furthermore, dose-volume histograms and dosimetric parameters were also analyzed using another set of patient data.

Results
The correlation between the auto-segmented and manual contours was acceptable for OARs, with a mean DSC higher than 0.80 for all OARs. In addition, the CTVs showed favorable results, with mean DSCs higher than 0.70 for all breast and regional lymph node CTVs. Furthermore, qualitative subjective scoring showed that the results were acceptable for all CTVs and OARs, with a median score of at least 8 (possible range: 0–10) for (1) the differences between manual and auto-segmented contours and (2) the extent to which auto-segmentation would assist physicians in clinical practice. The differences in dosimetric parameters between the auto-segmented and manual contours were minimal.