Ahmed R Eldesoky1, Esben S Yates2, Tine B Nyeng2, Mette S Thomsen2, Hanne M Nielsen3, Philip Poortmans4, Carine Kirkove5, Mechthild Krause6, Claus Kamby7, Ingvil Mjaaland8, Egil S Blix9, Ingelise Jensen10, Martin Berg11, Ebbe L Lorenzen12, Zahra Taheri-Kadkhoda13, Birgitte V Offersen14. 1. Department of Oncology, Aarhus University Hospital, Denmark; Department of Clinical Oncology and Nuclear Medicine, Mansoura University, Egypt. 2. Department of Medical Physics, Aarhus University Hospital, Denmark. 3. Department of Oncology, Aarhus University Hospital, Denmark. 4. Department of Radiation Oncology, Radboud University Medical Center, The Netherlands. 5. Department of Radiation Oncology, Catholic University of Louvain, Belgium. 6. German Cancer Consortium (DKTK) Dresden and German Cancer Research Center (DKFZ) Heidelberg, Department of Radiation Oncology and OncoRay, University Hospital Carl Gustav Carus, Technische Universität Dresden and Helmholtz-Zentrum Dresden-Rossendorf, Germany. 7. Department of Oncology, Rigshospitalet, Copenhagen, Denmark. 8. Department of Oncology, Stavanger University Hospital, Norway. 9. Department of Oncology, University Hospital of North Norway, Norway; Immunology Research group, Institute of Medical Biology, UiT The Arctic University of Norway, Tromsø, Norway. 10. Department of Medical Physics, Aalborg University Hospital, Denmark. 11. Department of Physics, Hospital of Vejle, Denmark. 12. Institute of Clinical Research, University of Southern Denmark, Odense, Denmark; Laboratory of Radiation Physics, Odense University Hospital, Denmark. 13. Department of Oncology, Hospital of Næstved, Denmark. 14. Department of Oncology, Aarhus University Hospital, Denmark. Electronic address: birgoffe@rm.dk.
Abstract
BACKGROUND AND PURPOSE: To internally and externally validate an atlas based automated segmentation (ABAS) in loco-regional radiation therapy of breast cancer. MATERIALS AND METHODS: Structures of 60 patients delineated according to the ESTRO consensus guideline were included in four categorized multi-atlas libraries using MIM Maestro™ software. These libraries were used for auto-segmentation in two different patient groups (50 patients from the local institution and 40 patients from other institutions). Dice Similarity Coefficient, Average Hausdorff Distance, difference in volume and time were computed to compare ABAS before and after correction against a gold standard manual segmentation (MS). RESULTS: ABAS reduced the time of MS before and after correction by 93% and 32%, respectively. ABAS showed high agreement for lung, heart, breast and humeral head, moderate agreement for chest wall and axillary nodal levels and poor agreement for interpectoral, internal mammary nodal regions and LADCA. Correcting ABAS significantly improved all the results. External validation of ABAS showed comparable results. CONCLUSIONS: ABAS is a clinically useful tool for segmenting structures in breast cancer loco-regional radiation therapy in a multi-institutional setting. However, manual correction of some structures is important before clinical use. The ABAS is now available for routine clinical use in Danish patients.
BACKGROUND AND PURPOSE: To internally and externally validate an atlas based automated segmentation (ABAS) in loco-regional radiation therapy of breast cancer. MATERIALS AND METHODS: Structures of 60 patients delineated according to the ESTRO consensus guideline were included in four categorized multi-atlas libraries using MIM Maestro™ software. These libraries were used for auto-segmentation in two different patient groups (50 patients from the local institution and 40 patients from other institutions). Dice Similarity Coefficient, Average Hausdorff Distance, difference in volume and time were computed to compare ABAS before and after correction against a gold standard manual segmentation (MS). RESULTS:ABAS reduced the time of MS before and after correction by 93% and 32%, respectively. ABAS showed high agreement for lung, heart, breast and humeral head, moderate agreement for chest wall and axillary nodal levels and poor agreement for interpectoral, internal mammary nodal regions and LADCA. Correcting ABAS significantly improved all the results. External validation of ABAS showed comparable results. CONCLUSIONS:ABAS is a clinically useful tool for segmenting structures in breast cancer loco-regional radiation therapy in a multi-institutional setting. However, manual correction of some structures is important before clinical use. The ABAS is now available for routine clinical use in Danish patients.
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