Purpose: Automated delineation of structures and organs is a key step in medical imaging. However, due to the large number and diversity of structures and the large variety of segmentation algorithms, a consensus is lacking as to which automated segmentation method works best for certain applications. Segmentation challenges are a good approach for unbiased evaluation and comparison of segmentation algorithms. Methods: In this work, we describe and present the results of the Head and Neck Auto-Segmentation Challenge 2015, a satellite event at the Medical Image Computing and Computer Assisted Interventions (MICCAI) 2015 conference. Six teams participated in a challenge to segment nine structures in the head and neck region of CT images: brainstem, mandible, chiasm, bilateral optic nerves, bilateral parotid glands, and bilateral submandibular glands. Results: This paper presents the quantitative results of this challenge using multiple established error metrics and a well-defined ranking system. The strengths and weaknesses of the different auto-segmentation approaches are analyzed and discussed. Conclusions: The Head and Neck Auto-Segmentation Challenge 2015 was a good opportunity to assess the current state-of-the-art in segmentation of organs at risk for radiotherapy treatment. Participating teams had the possibility to compare their approaches to other methods under unbiased and standardized circumstances. The results demonstrate a clear tendency toward more general purpose and fewer structure-specific segmentation algorithms.

Purpose: Intensity-modulated radiation therapy ͑IMRT͒ is the state of the art technique for head and neck cancer treatment. It requires precise delineation of the target to be treated and structures to be spared, which is currently done manually. The process is a time-consuming task of which the delineation of lymph node regions is often the longest step. Atlas-based delineation has been proposed as an alternative, but, in the authors' experience, this approach is not accurate enough for routine clinical use. Here, the authors improve atlas-based segmentation results obtained for level II-IV lymph node regions using an active shape model ͑ASM͒ approach. Methods: An average image volume was first created from a set of head and neck patient images with minimally enlarged nodes. The average image volume was then registered using affine, global, and local nonrigid transformations to the other volumes to establish a correspondence between surface points in the atlas and surface points in each of the other volumes. Once the correspondence was established, the ASMs were created for each node level. The models were then used to first constrain the results obtained with an atlas-based approach and then to iteratively refine the solution. Results: The method was evaluated through a leave-one-out experiment. The ASM-and atlas-based segmentations were compared to manual delineations via the Dice similarity coefficient ͑DSC͒ for volume overlap and the Euclidean distance between manual and automatic 3D surfaces. The mean DSC value obtained with the ASM-based approach is 10.7% higher than with the atlas-based approach; the mean and median surface errors were decreased by 13.6% and 12.0%, respectively. Conclusions: The ASM approach is effective in reducing segmentation errors in areas of low CT contrast where purely atlas-based methods are challenged. Statistical analysis shows that the improvements brought by this approach are significant.

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Automatic segmentation of left ventricle (LV) myocardium in cardiac short-axis cine MR images acquired on subjects with myocardial infarction is a challenging task, mainly because of the various types of image inhomogeneity caused by the infarctions. Among the approaches proposed to automate the LV myocardium segmentation task, methods based upon deep convolutional neural networks (CNN) have demonstrated their exceptional accuracy and robustness in recent years. However, most of the CNN-based approaches treat the frames in a cardiac cycle independently, which fails to capture the valuable dynamics of heart motion. Herein, an approach based on recurrent neural network (RNN), specifically a multi-level convolutional long short-term memory (ConvLSTM) model, is proposed to take the motion of the heart into consideration. Based on a ResNet-56 CNN, LV-related image features in consecutive frames of a cardiac cycle are extracted at both the low-and highresolution levels, which are processed by the corresponding multi-level ConvLSTM models to generate the myocardium segmentations. A leave-one-out experiment was carried out on a set of 3,600 cardiac cine MR slices collected in-house for 8 porcine subjects with surgically induced myocardial infarction. Compared with a solely CNN-based approach, the proposed approach demonstrated its superior robustness against image inhomogeneity by incorporating information from adjacent frames. It also outperformed a one-level ConvLSTM approach thanks to its capabilities to take advantage of image features at multiple resolution levels.Index Terms-Cardiac cine MRI, convolutional neural network, recurrent neural network, LSTM