Nadya Shusharina1, Jonas Söderberg2, David Edmunds1, Fredrik Löfman2, Helen Shih3, Thomas Bortfeld4. 1. Division of Radiation Biophysics, Massachusetts General Hospital and Harvard Medical School, Boston, USA. 2. RaySearch Laboratories, Stockholm, Sweden. 3. Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, USA. 4. Division of Radiation Biophysics, Massachusetts General Hospital and Harvard Medical School, Boston, USA. Electronic address: tbortfeld@mgh.harvard.edu.
Abstract
PURPOSE: Delineation of the clinical target volume (CTV) is arguably the weakest link in the treatment planning chain. This work aims to support clinicians in this crucial task. METHODS AND MATERIALS: While the CTV itself is ambiguous, it is much easier to identify structures that do not belong to the CTV and serve as barriers to the spread of the disease. We segment the known barrier structures using a convolutional neural network (CNN). The CTV is then obtained by starting from the manually delineated gross tumor volume (GTV) and expanding it while taking into account the barrier structures. Mathematically, we define the CTV as an iso-surface in the 3D map of shortest paths of all voxels from the GTV. The shortest paths are found with the Dijkstra algorithm. While the method is generally applicable, we test it on 206 glioma and glioblastoma cases. RESULTS: The auto-segmented barrier structures for the brain cases include the ventricles, falx cerebri, tentorium cerebelli, brain sinuses, and the outer surface of the brain. Manual and auto-segmented barrier structures agree with surface Dice Similarity Coefficients (DSC) ranging from 0.91 to 0.97 at 2 mm tolerance. Comparison of manual and automatically delineated CTVs shows a median surface DSC of 0.79. CONCLUSIONS: Barrier structures for CTV definition can be auto-delineated with outstanding precision using a CNN. An algorithm for automated calculation of the CTV by 3D expansion of the GTV while respecting anatomical barriers has been developed. It shows good agreement with manual CTV definition for brain tumors.
PURPOSE: Delineation of the clinical target volume (CTV) is arguably the weakest link in the treatment planning chain. This work aims to support clinicians in this crucial task. METHODS AND MATERIALS: While the CTV itself is ambiguous, it is much easier to identify structures that do not belong to the CTV and serve as barriers to the spread of the disease. We segment the known barrier structures using a convolutional neural network (CNN). The CTV is then obtained by starting from the manually delineated gross tumor volume (GTV) and expanding it while taking into account the barrier structures. Mathematically, we define the CTV as an iso-surface in the 3D map of shortest paths of all voxels from the GTV. The shortest paths are found with the Dijkstra algorithm. While the method is generally applicable, we test it on 206 glioma and glioblastoma cases. RESULTS: The auto-segmented barrier structures for the brain cases include the ventricles, falx cerebri, tentorium cerebelli, brain sinuses, and the outer surface of the brain. Manual and auto-segmented barrier structures agree with surface Dice Similarity Coefficients (DSC) ranging from 0.91 to 0.97 at 2 mm tolerance. Comparison of manual and automatically delineated CTVs shows a median surface DSC of 0.79. CONCLUSIONS: Barrier structures for CTV definition can be auto-delineated with outstanding precision using a CNN. An algorithm for automated calculation of the CTV by 3D expansion of the GTV while respecting anatomical barriers has been developed. It shows good agreement with manual CTV definition for brain tumors.
Authors: Liam S P Lawrence; Lee C L Chin; Rachel W Chan; Timothy K Nguyen; Arjun Sahgal; Chia-Lin Tseng; Angus Z Lau Journal: Radiat Oncol Date: 2021-04-13 Impact factor: 3.481