Evaluation of auto-segmentation for EBRT planning structures using deep learning-based workflow on cervical cancer

Abstract Deep learning (DL) based approach aims to construct a full workflow solution for cervical cancer with external beam radiation therapy (EBRT) and brachytherapy (BT). The purpose of this study was to evaluate the accuracy of EBRT planning structures derived from DL based auto-segmentation com...

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Main Authors: Jiahao Wang, Yuanyuan Chen, Hongling Xie, Lumeng Luo, Qiu Tang
Format: Article
Language:English
Published: Nature Portfolio 2022-08-01
Series:Scientific Reports
Online Access:https://doi.org/10.1038/s41598-022-18084-0
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author Jiahao Wang
Yuanyuan Chen
Hongling Xie
Lumeng Luo
Qiu Tang
author_facet Jiahao Wang
Yuanyuan Chen
Hongling Xie
Lumeng Luo
Qiu Tang
author_sort Jiahao Wang
collection DOAJ
description Abstract Deep learning (DL) based approach aims to construct a full workflow solution for cervical cancer with external beam radiation therapy (EBRT) and brachytherapy (BT). The purpose of this study was to evaluate the accuracy of EBRT planning structures derived from DL based auto-segmentation compared with standard manual delineation. Auto-segmentation model based on convolutional neural networks (CNN) was developed to delineate clinical target volumes (CTVs) and organs at risk (OARs) in cervical cancer radiotherapy. A total of 300 retrospective patients from multiple cancer centers were used to train and validate the model, and 75 independent cases were selected as testing data. The accuracy of auto-segmented contours were evaluated using geometric and dosimetric metrics including dice similarity coefficient (DSC), 95% hausdorff distance (95%HD), jaccard coefficient (JC) and dose-volume index (DVI). The correlation between geometric metrics and dosimetric difference was performed by Spearman’s correlation analysis. The right and left kidney, bladder, right and left femoral head showed superior geometric accuracy (DSC: 0.88–0.93; 95%HD: 1.03 mm–2.96 mm; JC: 0.78–0.88), and the Bland–Altman test obtained dose agreement for these contours (P > 0.05) between manual and DL based methods. Wilcoxon’s signed-rank test indicated significant dosimetric differences in CTV, spinal cord and pelvic bone (P < 0.001). A strong correlation between the mean dose of pelvic bone and its 95%HD (R = 0.843, P < 0.001) was found in Spearman’s correlation analysis, and the remaining structures showed weak link between dosimetric difference and all of geometric metrics. Our auto-segmentation achieved a satisfied agreement for most EBRT planning structures, although the clinical acceptance of CTV was a concern. DL based auto-segmentation was an essential component in cervical cancer workflow which would generate the accurate contouring.
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spelling doaj.art-09e415fd8bc744db9b3c68a18efacb8d2022-12-22T01:35:42ZengNature PortfolioScientific Reports2045-23222022-08-0112111210.1038/s41598-022-18084-0Evaluation of auto-segmentation for EBRT planning structures using deep learning-based workflow on cervical cancerJiahao Wang0Yuanyuan Chen1Hongling Xie2Lumeng Luo3Qiu Tang4Department of Radiation Oncology, Women’s Hospital, School of Medicine, Zhejiang UniversityDepartment of Radiation Oncology, Women’s Hospital, School of Medicine, Zhejiang UniversityDepartment of Radiation Oncology, Women’s Hospital, School of Medicine, Zhejiang UniversityDepartment of Radiation Oncology, Women’s Hospital, School of Medicine, Zhejiang UniversityDepartment of Radiation Oncology, Women’s Hospital, School of Medicine, Zhejiang UniversityAbstract Deep learning (DL) based approach aims to construct a full workflow solution for cervical cancer with external beam radiation therapy (EBRT) and brachytherapy (BT). The purpose of this study was to evaluate the accuracy of EBRT planning structures derived from DL based auto-segmentation compared with standard manual delineation. Auto-segmentation model based on convolutional neural networks (CNN) was developed to delineate clinical target volumes (CTVs) and organs at risk (OARs) in cervical cancer radiotherapy. A total of 300 retrospective patients from multiple cancer centers were used to train and validate the model, and 75 independent cases were selected as testing data. The accuracy of auto-segmented contours were evaluated using geometric and dosimetric metrics including dice similarity coefficient (DSC), 95% hausdorff distance (95%HD), jaccard coefficient (JC) and dose-volume index (DVI). The correlation between geometric metrics and dosimetric difference was performed by Spearman’s correlation analysis. The right and left kidney, bladder, right and left femoral head showed superior geometric accuracy (DSC: 0.88–0.93; 95%HD: 1.03 mm–2.96 mm; JC: 0.78–0.88), and the Bland–Altman test obtained dose agreement for these contours (P > 0.05) between manual and DL based methods. Wilcoxon’s signed-rank test indicated significant dosimetric differences in CTV, spinal cord and pelvic bone (P < 0.001). A strong correlation between the mean dose of pelvic bone and its 95%HD (R = 0.843, P < 0.001) was found in Spearman’s correlation analysis, and the remaining structures showed weak link between dosimetric difference and all of geometric metrics. Our auto-segmentation achieved a satisfied agreement for most EBRT planning structures, although the clinical acceptance of CTV was a concern. DL based auto-segmentation was an essential component in cervical cancer workflow which would generate the accurate contouring.https://doi.org/10.1038/s41598-022-18084-0
spellingShingle Jiahao Wang
Yuanyuan Chen
Hongling Xie
Lumeng Luo
Qiu Tang
Evaluation of auto-segmentation for EBRT planning structures using deep learning-based workflow on cervical cancer
Scientific Reports
title Evaluation of auto-segmentation for EBRT planning structures using deep learning-based workflow on cervical cancer
title_full Evaluation of auto-segmentation for EBRT planning structures using deep learning-based workflow on cervical cancer
title_fullStr Evaluation of auto-segmentation for EBRT planning structures using deep learning-based workflow on cervical cancer
title_full_unstemmed Evaluation of auto-segmentation for EBRT planning structures using deep learning-based workflow on cervical cancer
title_short Evaluation of auto-segmentation for EBRT planning structures using deep learning-based workflow on cervical cancer
title_sort evaluation of auto segmentation for ebrt planning structures using deep learning based workflow on cervical cancer
url https://doi.org/10.1038/s41598-022-18084-0
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