Semiautomated four-dimensional computed tomography segmentation using deformable models.

The purpose of this work is to demonstrate a proof of feasibility of the application of a commercial prototype deformable model algorithm to the problem of delineation of anatomic structures on four-dimensional (4D) computed tomography (CT) image data sets. We acquired a 4D CT image data set of a patient's thorax that consisted of three-dimensional (3D) image data sets from eight phases in the respiratory cycle. The contours of the right and left lungs, cord, heart, and esophagus were manually delineated on the end inspiration data set. An interactive deformable model algorithm, originally intended for deforming an atlas-based model surface to a 3D CT image data set, was applied in an automated fashion. Triangulations based on the contours generated on each phase were deformed to the CT data set on the succeeding phase to generate the contours on that phase. Deformation was propagated through the eight phases, and the contours obtained on the end inspiration data set were compared with the original manually delineated contours. Structures defined by high-density gradients, such as lungs, cord, and heart, were accurately reproduced, except in regions where other gradient boundaries may have confused the algorithm, such as near bronchi. The algorithm failed to accurately contour the esophagus, a soft-tissue structure completely surrounded by tissue of similar density, without manual interaction. This technique has the potential to facilitate contour delineation in 4D CT image data sets; and future evolution of the software is expected to improve the process.