Semiautomated segmentation of head and neck cancers in 18F‐FDG PET scans: A just‐enough‐interaction approach

Beichel, Reinhard; Tol, Markus Van; Ulrich, Ethan; Bauer, Christian; Chang, T.-P.; Plichta, Kristin A.; Smith, Brian J.; Sunderland, John; Graham, Michael M.; Sonka, Milan; Buatti, John M.

doi:10.1118/1.4948679

Cited by 51 publications

(56 citation statements)

References 40 publications

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“…It is likely that human supervision will remain necessary, both before and after the process of automatic contouring, although this rule may change in the future . A recent work has presented a method for head‐and‐neck, in which user interaction is kept minimal but exploited nonetheless so that the user can provide simple cues to guide the segmentation algorithm in an efficient and intuitive manner …”

Section: Discussion Of Segmentation Limitations Dependencies and Immentioning

confidence: 99%

Classification and evaluation strategies of auto-segmentation approaches for PET: Report of AAPM task group No. 211

et al. 2017

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Purpose The purpose of this educational report is to provide an overview of the present state-of-the-art PET auto-segmentation (PET-AS) algorithms and their respective validation, with an emphasis on providing the user with help in understanding the challenges and pitfalls associated with selecting and implementing a PET-AS algorithm for a particular application. Approach A brief description of the different types of PET-AS algorithms is provided using a classification based on method complexity and type. The advantages and the limitations of the current PET-AS algorithms are highlighted based on current publications and existing comparison studies. A review of the available image datasets and contour evaluation metrics in terms of their applicability for establishing a standardized evaluation of PET-AS algorithms is provided. The performance requirements for the algorithms and their dependence on the application, the radiotracer used and the evaluation criteria are described and discussed. Finally, a procedure for algorithm acceptance and implementation, as well as the complementary role of manual and auto-segmentation are addressed. Findings A large number of PET-AS algorithms have been developed within the last 20 years. Many of the proposed algorithms are based on either fixed or adaptively selected thresholds. More recently, numerous papers have proposed the use of more advanced image analysis paradigms to perform semi-automated delineation of the PET images. However, the level of algorithm validation is variable and for most published algorithms is either insufficient or inconsistent which prevents recommending a single algorithm. This is compounded by the fact that realistic image configurations with low signal-to-noise ratios (SNR) and heterogeneous tracer distributions have rarely been used. Large variations in the evaluation methods used in the literature point to the need for a standardized evaluation protocol. Conclusions Available comparison studies suggest that PET-AS algorithms relying on advanced image analysis paradigms provide generally more accurate segmentation than approaches based on PET activity thresholds, particularly for realistic configurations. However, this may not be the case for simple shape lesions in situations with a narrower range of parameters, where simpler methods may also perform well. Recent algorithms which employ some type of consensus or automatic selection between several PET-AS methods have potential to overcome the limitations of the individual methods when appropriately trained. In either case, accuracy evaluation is required for each different PET scanner and scanning and image reconstruction protocol. For the simpler, less robust approaches, adaptation to scanning conditions, tumor type, and tumor location by optimization of parameters is necessary. The results from the method evaluation stage can be used to estimate the contouring uncertainty. All PET-AS contours should be critically verified by a physician. A standard test, i.e., a benchmark dedicated to ...

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Section: Discussion Of Segmentation Limitations Dependencies and Immentioning

confidence: 99%

Classification and evaluation strategies of auto-segmentation approaches for PET: Report of AAPM task group No. 211

et al. 2017

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“…Due to the lack of a ground truth for tumors, we chose MTV 1 to be the reference, gold standard, tumor volume due to the physician's experience. Subsequently, we generated semiautomated graphical‐based volumes (GBSV) based on the method reported by Beichel et al42 For further information about this method, the reader is encouraged to review the cited article. This approach is implemented as an extension for 3D Slicer software (https://www.slicer.org/), an open source software package to visualize and analyze medical images.…”

Section: Methodsmentioning

confidence: 99%

Reproducibility of F18‐FDG PET radiomic features for different cervical tumor segmentation methods, gray‐level discretization, and reconstruction algorithms

Altazi

Zhang

Fernandez

et al. 2017

J Applied Clin Med Phys

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Site‐specific investigations of the role of radiomics in cancer diagnosis and therapy are emerging. We evaluated the reproducibility of radiomic features extracted from 18Flourine–fluorodeoxyglucose (18F‐FDG) PET images for three parameters: manual versus computer‐aided segmentation methods, gray‐level discretization, and PET image reconstruction algorithms. Our cohort consisted of pretreatment PET/CT scans from 88 cervical cancer patients. Two board‐certified radiation oncologists manually segmented the metabolic tumor volume (MTV1 and MTV2) for each patient. For comparison, we used a graphical‐based method to generate semiautomated segmented volumes (GBSV). To address any perturbations in radiomic feature values, we down‐sampled the tumor volumes into three gray‐levels: 32, 64, and 128 from the original gray‐level of 256. Finally, we analyzed the effect on radiomic features on PET images of eight patients due to four PET 3D‐reconstruction algorithms: maximum likelihood‐ordered subset expectation maximization (OSEM) iterative reconstruction (IR) method, fourier rebinning‐ML‐OSEM (FOREIR), FORE‐filtered back projection (FOREFBP), and 3D‐Reprojection (3DRP) analytical method. We extracted 79 features from all segmentation method, gray‐levels of down‐sampled volumes, and PET reconstruction algorithms. The features were extracted using gray‐level co‐occurrence matrices (GLCM), gray‐level size zone matrices (GLSZM), gray‐level run‐length matrices (GLRLM), neighborhood gray‐tone difference matrices (NGTDM), shape‐based features (SF), and intensity histogram features (IHF). We computed the Dice coefficient between each MTV and GBSV to measure segmentation accuracy. Coefficient values close to one indicate high agreement, and values close to zero indicate low agreement. We evaluated the effect on radiomic features by calculating the mean percentage differences (d¯) between feature values measured from each pair of parameter elements (i.e. segmentation methods: MTV1‐MTV2, MTV1‐GBSV, MTV2‐GBSV; gray‐levels: 64‐32, 64‐128, and 64‐256; reconstruction algorithms: OSEM‐FORE‐OSEM, OSEM‐FOREFBP, and OSEM‐3DRP). We used false|normald¯false| as a measure of radiomic feature reproducibility level, where any feature scored false|normald¯false| ±SD ≤ |25|% ± 35% was considered reproducible. We used Bland–Altman analysis to evaluate the mean, standard deviation (SD), and upper/lower reproducibility limits (U/LRL) for radiomic features in response to variation in each testing parameter. Furthermore, we proposed U/LRL as a method to classify the level of reproducibility: High— ±1% ≤ U/LRL ≤ ±30%; Intermediate— ±30% < U/LRL ≤ ±45%; Low— ±45 < U/LRL ≤ ±50%. We considered any feature below the low level as nonreproducible (NR). Finally, we calculated the interclass correlation coefficient (ICC) to evaluate the reliability of radiomic feature measurements for each parameter. The segmented volumes of 65 patients (81.3%) scored Dice coefficient >0.75 for all three volumes. The result outcomes revealed a tendency of higher radiomic fe...

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“…However, we expect this supplementary segmentation tool would act as an aid and would improve the robustness and consistency of contouring. Beichel at al . compared a semiautomated segmentation vs experts contouring method, and presented the intra‐ and interoperator standard deviations that were significantly lower for the semi‐automated segmentation.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous cosegmentation of tumors in PET‐CT images using deep fully convolutional networks

et al. 2019

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Purpose To investigate the use and efficiency of 3‐D deep learning, fully convolutional networks (DFCN) for simultaneous tumor cosegmentation on dual‐modality nonsmall cell lung cancer (NSCLC) and positron emission tomography (PET)‐computed tomography (CT) images. Methods We used DFCN cosegmentation for NSCLC tumors in PET‐CT images, considering both the CT and PET information. The proposed DFCN‐based cosegmentation method consists of two coupled three‐dimensional (3D)‐UNets with an encoder‐decoder architecture, which can communicate with the other in order to share complementary information between PET and CT. The weighted average sensitivity and positive predictive values denoted as Scores, dice similarity coefficients (DSCs), and the average symmetric surface distances were used to assess the performance of the proposed approach on 60 pairs of PET/CTs. A Simultaneous Truth and Performance Level Estimation Algorithm (STAPLE) of 3 expert physicians’ delineations were used as a reference. The proposed DFCN framework was compared to 3 graph‐based cosegmentation methods. Results Strong agreement was observed when using the STAPLE references for the proposed DFCN cosegmentation on the PET‐CT images. The average DSCs on CT and PET are 0.861 ± 0.037 and 0.828 ± 0.087, respectively, using DFCN, compared to 0.638 ± 0.165 and 0.643 ± 0.141, respectively, when using the graph‐based cosegmentation method. The proposed DFCN cosegmentation using both PET and CT also outperforms the deep learning method using either PET or CT alone. Conclusions The proposed DFCN cosegmentation is able to outperform existing graph‐based segmentation methods. The proposed DFCN cosegmentation shows promise for further integration with quantitative multimodality imaging tools in clinical trials.

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Semiautomated segmentation of head and neck cancers in 18F‐FDG PET scans: A just‐enough‐interaction approach

Cited by 51 publications

References 40 publications

Classification and evaluation strategies of auto-segmentation approaches for PET: Report of AAPM task group No. 211

Classification and evaluation strategies of auto-segmentation approaches for PET: Report of AAPM task group No. 211

Reproducibility of F18‐FDG PET radiomic features for different cervical tumor segmentation methods, gray‐level discretization, and reconstruction algorithms

Simultaneous cosegmentation of tumors in PET‐CT images using deep fully convolutional networks

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