A review of segmentation and deformable registration methods applied to adaptive cervical cancer radiation therapy treatment planning

Objective: Manual contouring and registration for radiotherapy treatment planning and online adaptation for cervical cancer radiation therapy in computed tomography (CT) and magnetic resonance images (MRI) are often necessary. However manual intervention is time consuming and may suffer from inter or intra-rater variability. In recent years a number of computer-guided automatic or semi-automatic segmentation and registration methods have been proposed. Segmentation and registration in CT and MRI for this purpose is a challenging task due to soft tissue deformation, inter-patient shape and appearance variation and anatomical changes over the course of treatment. The objective of this work is to provide a state-of-the-art review of computer-aided methods developed for adaptive treatment planning and radiation therapy planning for cervical cancer radiation therapy. Methods: Segmentation and registration methods published with the goal of cervical cancer treatment planning and adaptation have been identified from the literature (PubMed and Google Scholar). A comprehensive description of each method is provided. Similarities and differences of these methods are highlighted and the strengths and weaknesses of these methods are discussed. A discussion about choice of an appropriate method for a given modality is provided. Results: In the reviewed papers a Dice similarity coefficient of around 0.85 along with mean absolute surface distance of 2-4. mm for the clinically treated volume were reported for transfer of contours from planning day to the treatment day. Conclusions: Most segmentation and non-rigid registration methods have been primarily designed for adaptive re-planning for the transfer of contours from planning day to the treatment day. The use of shape priors significantly improved segmentation and registration accuracy compared to other models

A review of algorithms for medical image segmentation and their applications to the female pelvic cavity

This paper aims to make a review on the current segmentation algorithms used for medical images. Algorithms are classified according to their principal methodologies, namely the ones based on thresholds, the ones based on clustering techniques and the ones based on deformable models. The last type is focused on due to the intensive investigations into the deformable models that have been done in the last few decades. Typical algorithms of each type are discussed and the main ideas, application fields, advantages and disadvantages of each type are summarised. Experiments that apply these algorithms to segment the organs and tissues of the female pelvic cavity are presented to further illustrate their distinct characteristics. In the end, the main guidelines that should be considered for designing the segmentation algorithms of the pelvic cavity are proposed

Estimation of vector fields in unconstrained and inequality constrained variational problems for segmentation and registration

Vector fields arise in many problems of computer vision, particularly in non-rigid registration. In this paper, we develop coupled partial differential equations (PDEs) to estimate vector fields that define the deformation between objects, and the contour or surface that defines the segmentation of the objects as well.We also explore the utility of inequality constraints applied to variational problems in vision such as estimation of deformation fields in non-rigid registration and tracking. To solve inequality constrained vector field estimation problems, we apply tools from the Kuhn-Tucker theorem in optimization theory. Our technique differs from recently popular joint segmentation and registration algorithms, particularly in its coupled set of PDEs derived from the same set of energy terms for registration and segmentation. We present both the theory and results that demonstrate our approach

Computational Anatomy for Multi-Organ Analysis in Medical Imaging: A Review

The medical image analysis field has traditionally been focused on the development of organ-, and disease-specific methods. Recently, the interest in the development of more 20 comprehensive computational anatomical models has grown, leading to the creation of multi-organ models. Multi-organ approaches, unlike traditional organ-specific strategies, incorporate inter-organ relations into the model, thus leading to a more accurate representation of the complex human anatomy. Inter-organ relations are not only spatial, but also functional and physiological. Over the years, the strategies 25 proposed to efficiently model multi-organ structures have evolved from the simple global modeling, to more sophisticated approaches such as sequential, hierarchical, or machine learning-based models. In this paper, we present a review of the state of the art on multi-organ analysis and associated computation anatomy methodology. The manuscript follows a methodology-based classification of the different techniques 30 available for the analysis of multi-organs and multi-anatomical structures, from techniques using point distribution models to the most recent deep learning-based approaches. With more than 300 papers included in this review, we reflect on the trends and challenges of the field of computational anatomy, the particularities of each anatomical region, and the potential of multi-organ analysis to increase the impact of 35 medical imaging applications on the future of healthcare.Comment: Paper under revie

Semi-Automatic Segmentation of Normal Female Pelvic Floor Structures from Magnetic Resonance Images

Stress urinary incontinence (SUI) and pelvic organ prolapse (POP) are important health issues affecting millions of American women. Investigation of the cause of SUI and POP requires a better understand of the anatomy of female pelvic floor. In addition, pre-surgical planning and individualized treatment plans require development of patient-specific three-dimensional or virtual reality models. The biggest challenge in building those models is to segment pelvic floor structures from magnetic resonance images because of their complex shapes, which make manual segmentation labor-intensive and inaccurate. In this dissertation, a quick and reliable semi-automatic segmentation method based on a shape model is proposed. The model is built on statistical analysis of the shapes of structures in a training set. A local feature map of the target image is obtained by applying a filtering pipeline, including contrast enhancement, noise reduction, smoothing, and edge extraction. With the shape model and feature map, automatic segmentation is performed by matching the model to the border of the structure using an optimization technique called evolution strategy. Segmentation performance is evaluated by calculating a similarity coefficient between semi-automatic and manual segmentation results. Taguchi analysis is performed to investigate the significance of segmentation parameters and provide tuning trends for better performance. The proposed method was successfully tested on both two-dimensional and three-dimensional image segmentation using the levator ani and obturator muscles as examples. Although the method is designed for segmentation of female pelvic floor structures, it can also be applied to other structures or organs without large shape variatio

Semi-Automatic Segmentation of Normal Female Pelvic Floor Structures from Magnetic Resonance Images

Stress urinary incontinence (SUI) and pelvic organ prolapse (POP) are important health issues affecting millions of American women. Investigation of the cause of SUI and POP requires a better understand of the anatomy of female pelvic floor. In addition, pre-surgical planning and individualized treatment plans require development of patient-specific three-dimensional or virtual reality models. The biggest challenge in building those models is to segment pelvic floor structures from magnetic resonance images because of their complex shapes, which make manual segmentation labor-intensive and inaccurate. In this dissertation, a quick and reliable semi-automatic segmentation method based on a shape model is proposed. The model is built on statistical analysis of the shapes of structures in a training set. A local feature map of the target image is obtained by applying a filtering pipeline, including contrast enhancement, noise reduction, smoothing, and edge extraction. With the shape model and feature map, automatic segmentation is performed by matching the model to the border of the structure using an optimization technique called evolution strategy. Segmentation performance is evaluated by calculating a similarity coefficient between semi-automatic and manual segmentation results. Taguchi analysis is performed to investigate the significance of segmentation parameters and provide tuning trends for better performance. The proposed method was successfully tested on both two-dimensional and three-dimensional image segmentation using the levator ani and obturator muscles as examples. Although the method is designed for segmentation of female pelvic floor structures, it can also be applied to other structures or organs without large shape variatio

Semi-Automatic Segmentation of Normal Female Pelvic Floor Structures from Magnetic Resonance Images

Stress urinary incontinence (SUI) and pelvic organ prolapse (POP) are important health issues affecting millions of American women. Investigation of the cause of SUI and POP requires a better understand of the anatomy of female pelvic floor. In addition, pre-surgical planning and individualized treatment plans require development of patient-specific three-dimensional or virtual reality models. The biggest challenge in building those models is to segment pelvic floor structures from magnetic resonance images because of their complex shapes, which make manual segmentation labor-intensive and inaccurate. In this dissertation, a quick and reliable semi-automatic segmentation method based on a shape model is proposed. The model is built on statistical analysis of the shapes of structures in a training set. A local feature map of the target image is obtained by applying a filtering pipeline, including contrast enhancement, noise reduction, smoothing, and edge extraction. With the shape model and feature map, automatic segmentation is performed by matching the model to the border of the structure using an optimization technique called evolution strategy. Segmentation performance is evaluated by calculating a similarity coefficient between semi-automatic and manual segmentation results. Taguchi analysis is performed to investigate the significance of segmentation parameters and provide tuning trends for better performance. The proposed method was successfully tested on both two-dimensional and three-dimensional image segmentation using the levator ani and obturator muscles as examples. Although the method is designed for segmentation of female pelvic floor structures, it can also be applied to other structures or organs without large shape variatio

Regmentation: A New View of Image Segmentation and Registration

Image segmentation and registration have been the two major areas of research in the medical imaging community for decades and still are. In the context of radiation oncology, segmentation and registration methods are widely used for target structure definition such as prostate or head and neck lymph node areas. In the past two years, 45% of all articles published in the most important medical imaging journals and conferences have presented either segmentation or registration methods. In the literature, both categories are treated rather separately even though they have much in common. Registration techniques are used to solve segmentation tasks (e.g. atlas based methods) and vice versa (e.g. segmentation of structures used in a landmark based registration). This article reviews the literature on image segmentation methods by introducing a novel taxonomy based on the amount of shape knowledge being incorporated in the segmentation process. Based on that, we argue that all global shape prior segmentation methods are identical to image registration methods and that such methods thus cannot be characterized as either image segmentation or registration methods. Therefore we propose a new class of methods that are able solve both segmentation and registration tasks. We call it regmentation. Quantified on a survey of the current state of the art medical imaging literature, it turns out that 25% of the methods are pure registration methods, 46% are pure segmentation methods and 29% are regmentation methods. The new view on image segmentation and registration provides a consistent taxonomy in this context and emphasizes the importance of regmentation in current medical image processing research and radiation oncology image-guided applications