Abstract. In this paper, we present a novel method by incorporating information theory into the learning-based approach for automatic and accurate pelvic organ segmentation (including the prostate, bladder and rectum). We target 3D CT volumes that are generated using different scanning protocols (e.g., contrast and non-contrast, with and without implant in the prostate, various resolution and position), and the volumes come from largely diverse sources (e.g., diseased in different organs). Three key ingredients are combined to solve this challenging segmentation problem. First, marginal space learning (MSL) is applied to efficiently and effectively localize the multiple organs in the largely diverse CT volumes. Second, learning techniques, steerable features, are applied for robust boundary detection. This enables handling of highly heterogeneous texture pattern. Third, a novel information theoretic scheme is incorporated into the boundary inference process. The incorporation of the Jensen-Shannon divergence further drives the mesh to the best fit of the image, thus improves the segmentation performance. The proposed approach is tested on a challenging dataset containing 188 volumes from diverse sources. Our approach not only produces excellent segmentation accuracy, but also runs about eighty times faster than previous state-of-the-art solutions. The proposed method can be applied to CT images to provide visual guidance to physicians during the computer-aided diagnosis, treatment planning and image-guided radiotherapy to treat cancers in pelvic region.

In the past years sophisticated automatic segmentation algorithms for various medical image segmentation problems have been developed. However, there are always cases where automatic algorithms fail to provide an acceptable segmentation. In these cases the user needs efficient segmentation editing tools, a problem which has not received much attention in research. We give a comprehensive overview on segmentation editing for three-dimensional (3D) medical images. For segmentation editing in two-dimensional (2D) images, we discuss a sketch-based approach where the user modifies the segmentation in the contour domain. Based on this 2D interface, we present an image-based as well as an image-independent method for intuitive and efficient segmentation editing in 3D in the context of tumour segmentation in computed tomography (CT). Our editing tools have been evaluated on a database containing 1226 representative liver metastases, lung nodules and lymph nodes of different shape, size and image quality. In addition, we have performed a qualitative evaluation with radiologists and technical experts, proving the efficiency of our tools.

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Dedicated visualization methods are among the most important tools of modern computer-aided medical applications. Reformation methods such as Multiplanar Reformation or Curved Planar Reformation have evolved as useful tools that facilitate diagnostic and therapeutic work. In this paper, we present a novel approach that can be seen as a generalization of Multiplanar Reformation to curved surfaces. The main concept is to generate reformatted medical volumes driven by the individual anatomical geometry of a specific patient. This process generates flat views of anatomical structures that facilitate many tasks such as diagnosis, navigation and annotation. Our reformation framework is based on a non-linear as-rigid-as-possible volumetric deformation scheme that uses generic triangular surface meshes as input. To manage inevitable distortions during reformation, we introduce importance maps which allow controlling the error distribution and improving the overall visual quality in areas of elevated interest. Our method seamlessly integrates with well-established concepts such as the slice-based inspection of medical datasets and we believe it can improve the overall efficiency of many medical workflows. To demonstrate this, we additionally present an integrated visualization system and discuss several use cases that substantiate its benefits.

Rationale and objectives Tumor volume change has potential as a biomarker for diagnosis, therapy planning, and treatment response. Precision was evaluated and compared among semi-automated lung tumor volume measurement algorithms from clinical thoracic CT datasets. The results inform approaches and testing requirements for establishing conformance with the Quantitative Imaging Biomarker Alliance (QIBA) CT Volumetry Profile. Materials and Methods Industry and academic groups participated in a challenge study. Intra-algorithm repeatability and inter-algorithm reproducibility were estimated. Relative magnitudes of various sources of variability were estimated using a linear mixed effects model. Segmentation boundaries were compared to provide a basis on which to optimize algorithm performance for developers. Results Intra-algorithm repeatability ranged from 13% (best performing) to 100% (least performing), with most algorithms demonstrating improved repeatability as the tumor size increased. Inter-algorithm reproducibility determined in three partitions and found to be 58% for the four best performing groups, 70% for the set of groups meeting repeatability requirements, and 84% when all groups but the least performer were included. The best performing partition performed markedly better on tumors with equivalent diameters above 40 mm. Larger tumors benefitted by human editing but smaller tumors did not. One-fifth to one-half of the total variability came from sources independent of the algorithms. Segmentation boundaries differed substantially, not just in overall volume but in detail. Conclusions Nine of the twelve participating algorithms pass precision requirements similar to what is indicated in the QIBA Profile, with the caveat that the current study was not designed to explicitly evaluate algorithm Profile conformance. Change in tumor volume can be measured with confidence to within ±14% using any of these nine algorithms on tumor sizes above 10 mm. No partition of the algorithms were able to meet the QIBA requirements for interchangeability down to 10 mm, though the partition comprised of the best performing algorithms did meet this requirement above a tumor size of approximately 40 mm.