88 research outputs found

    Esophageal tumor segmentation in CT images using a Dilated Dense Attention Unet (DDAUnet)

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    Manual or automatic delineation of the esophageal tumor in CT images is known to be very challenging. This is due to the low contrast between the tumor and adjacent tissues, the anatomical variation of the esophagus, as well as the occasional presence of foreign bodies (e.g. feeding tubes). Physicians therefore usually exploit additional knowledge such as endoscopic findings, clinical history, additional imaging modalities like PET scans. Achieving his additional information is time-consuming, while the results are error-prone and might lead to non-deterministic results. In this paper we aim to investigate if and to what extent a simplified clinical workflow based on CT alone, allows one to automatically segment the esophageal tumor with sufficient quality. For this purpose, we present a fully automatic end-to-end esophageal tumor segmentation method based on convolutional neural networks (CNNs). The proposed network, called Dilated Dense Attention Unet (DDAUnet), leverages spatial and channel attention gates in each dense block to selectively concentrate on determinant feature maps and regions. Dilated convolutional layers are used to manage GPU memory and increase the network receptive field. We collected a dataset of 792 scans from 288 distinct patients including varying anatomies with air pockets, feeding tubes and proximal tumors. Repeatability and reproducibility studies were conducted for three distinct splits of training and validation sets. The proposed network achieved a DSC value of 0.79 +/- 0.20, a mean surface distance of 5.4 +/- 20.2mm and 95% Hausdorff distance of 14.7 +/- 25.0mm for 287 test scans, demonstrating promising results with a simplified clinical workflow based on CT alone. Our code is publicly available via https://github.com/yousefis/DenseUnet_Esophagus_Segmentation.Biological, physical and clinical aspects of cancer treatment with ionising radiatio

    Incorporating Cardiac Substructures Into Radiation Therapy For Improved Cardiac Sparing

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    Growing evidence suggests that radiation therapy (RT) doses to the heart and cardiac substructures (CS) are strongly linked to cardiac toxicities, though only the heart is considered clinically. This work aimed to utilize the superior soft-tissue contrast of magnetic resonance (MR) to segment CS, quantify uncertainties in their position, assess their effect on treatment planning and an MR-guided environment. Automatic substructure segmentation of 12 CS was completed using a novel hybrid MR/computed tomography (CT) atlas method and was improved upon using a 3-dimensional neural network (U-Net) from deep learning. Intra-fraction motion due to respiration was then quantified. The inter-fraction setup uncertainties utilizing a novel MR-linear accelerator were also quantified. Treatment planning comparisons were performed with and without substructure inclusions and methods to reduce radiation dose to sensitive CS were evaluated. Lastly, these described technologies (deep learning U-Net) were translated to an MR-linear accelerator and a segmentation pipeline was created. Automatic segmentations from the hybrid MR/CT atlas was able to generate accurate segmentations for the chambers and great vessels (Dice similarity coefficient (DSC) \u3e 0.75) but coronary artery segmentations were unsuccessful (DSC\u3c0.3). After implementing deep learning, DSC for the chambers and great vessels was ≥0.85 along with an improvement in the coronary arteries (DSC\u3e0.5). Similar accuracy was achieved when implementing deep learning for MR-guided RT. On average, automatic segmentations required ~10 minutes to generate per patient and deep learning only required 14 seconds. The inclusion of CS in the treatment planning process did not yield statistically significant changes in plan complexity, PTV, or OAR dose. Automatic segmentation results from deep learning pose major efficiency and accuracy gains for CS segmentation offering high potential for rapid implementation into radiation therapy planning for improved cardiac sparing. Introducing CS into RT planning for MR-guided RT presented an opportunity for more effective sparing with limited increase in plan complexity

    Incorporating Cardiac Substructures Into Radiation Therapy For Improved Cardiac Sparing

    Get PDF
    Growing evidence suggests that radiation therapy (RT) doses to the heart and cardiac substructures (CS) are strongly linked to cardiac toxicities, though only the heart is considered clinically. This work aimed to utilize the superior soft-tissue contrast of magnetic resonance (MR) to segment CS, quantify uncertainties in their position, assess their effect on treatment planning and an MR-guided environment. Automatic substructure segmentation of 12 CS was completed using a novel hybrid MR/computed tomography (CT) atlas method and was improved upon using a 3-dimensional neural network (U-Net) from deep learning. Intra-fraction motion due to respiration was then quantified. The inter-fraction setup uncertainties utilizing a novel MR-linear accelerator were also quantified. Treatment planning comparisons were performed with and without substructure inclusions and methods to reduce radiation dose to sensitive CS were evaluated. Lastly, these described technologies (deep learning U-Net) were translated to an MR-linear accelerator and a segmentation pipeline was created. Automatic segmentations from the hybrid MR/CT atlas was able to generate accurate segmentations for the chambers and great vessels (Dice similarity coefficient (DSC) \u3e 0.75) but coronary artery segmentations were unsuccessful (DSC\u3c0.3). After implementing deep learning, DSC for the chambers and great vessels was ≥0.85 along with an improvement in the coronary arteries (DSC\u3e0.5). Similar accuracy was achieved when implementing deep learning for MR-guided RT. On average, automatic segmentations required ~10 minutes to generate per patient and deep learning only required 14 seconds. The inclusion of CS in the treatment planning process did not yield statistically significant changes in plan complexity, PTV, or OAR dose. Automatic segmentation results from deep learning pose major efficiency and accuracy gains for CS segmentation offering high potential for rapid implementation into radiation therapy planning for improved cardiac sparing. Introducing CS into RT planning for MR-guided RT presented an opportunity for more effective sparing with limited increase in plan complexity

    Machine Learning towards General Medical Image Segmentation

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    The quality of patient care associated with diagnostic radiology is proportionate to a physician\u27s workload. Segmentation is a fundamental limiting precursor to diagnostic and therapeutic procedures. Advances in machine learning aims to increase diagnostic efficiency to replace single applications with generalized algorithms. We approached segmentation as a multitask shape regression problem, simultaneously predicting coordinates on an object\u27s contour while jointly capturing global shape information. Shape regression models inherent point correlations to recover ambiguous boundaries not supported by clear edges and region homogeneity. Its capabilities was investigated using multi-output support vector regression (MSVR) on head and neck (HaN) CT images. Subsequently, we incorporated multiplane and multimodality spinal images and presented the first deep learning multiapplication framework for shape regression, the holistic multitask regression network (HMR-Net). MSVR and HMR-Net\u27s performance were comparable or superior to state-of-the-art algorithms. Multiapplication frameworks bridges any technical knowledge gaps and increases workflow efficiency

    MA-SAM: Modality-agnostic SAM Adaptation for 3D Medical Image Segmentation

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    The Segment Anything Model (SAM), a foundation model for general image segmentation, has demonstrated impressive zero-shot performance across numerous natural image segmentation tasks. However, SAM's performance significantly declines when applied to medical images, primarily due to the substantial disparity between natural and medical image domains. To effectively adapt SAM to medical images, it is important to incorporate critical third-dimensional information, i.e., volumetric or temporal knowledge, during fine-tuning. Simultaneously, we aim to harness SAM's pre-trained weights within its original 2D backbone to the fullest extent. In this paper, we introduce a modality-agnostic SAM adaptation framework, named as MA-SAM, that is applicable to various volumetric and video medical data. Our method roots in the parameter-efficient fine-tuning strategy to update only a small portion of weight increments while preserving the majority of SAM's pre-trained weights. By injecting a series of 3D adapters into the transformer blocks of the image encoder, our method enables the pre-trained 2D backbone to extract third-dimensional information from input data. The effectiveness of our method has been comprehensively evaluated on four medical image segmentation tasks, by using 10 public datasets across CT, MRI, and surgical video data. Remarkably, without using any prompt, our method consistently outperforms various state-of-the-art 3D approaches, surpassing nnU-Net by 0.9%, 2.6%, and 9.9% in Dice for CT multi-organ segmentation, MRI prostate segmentation, and surgical scene segmentation respectively. Our model also demonstrates strong generalization, and excels in challenging tumor segmentation when prompts are used. Our code is available at: https://github.com/cchen-cc/MA-SAM
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