A semiautomatic CT-based ensemble segmentation of lung tumors: Comparison with oncologists’ delineations and with the surgical specimen

AbstractPurposeTo assess the clinical relevance of a semiautomatic CT-based ensemble segmentation method, by comparing it to pathology and to CT/PET manual delineations by five independent radiation oncologists in non-small cell lung cancer (NSCLC).Materials and methodsFor 20 NSCLC patients (stages Ib–IIIb) the primary tumor was delineated manually on CT/PET scans by five independent radiation oncologists and segmented using a CT based semi-automatic tool. Tumor volume and overlap fractions between manual and semiautomatic-segmented volumes were compared. All measurements were correlated with the maximal diameter on macroscopic examination of the surgical specimen. Imaging data are available on www.cancerdata.org.ResultsHigh overlap fractions were observed between the semi-automatically segmented volumes and the intersection (92.5±9.0, mean±SD) and union (94.2±6.8) of the manual delineations. No statistically significant differences in tumor volume were observed between the semiautomatic segmentation (71.4±83.2cm3, mean±SD) and manual delineations (81.9±94.1cm3; p=0.57). The maximal tumor diameter of the semiautomatic-segmented tumor correlated strongly with the macroscopic diameter of the primary tumor (r=0.96).ConclusionsSemiautomatic segmentation of the primary tumor on CT demonstrated high agreement with CT/PET manual delineations and strongly correlated with the macroscopic diameter considered as the “gold standard”. This method may be used routinely in clinical practice and could be employed as a starting point for treatment planning, target definition in multi-center clinical trials or for high throughput data mining research. This method is particularly suitable for peripherally located tumors

Fast volumetric registration method for tumor follow-up in pulmonary CT exams

An oncological patient may go through several tomographic acquisitions during a period of time, needing an appropriate registration. We propose an automatic volumetric intrapatient registration method for tumor follow-up in pulmonary CT exams. The performance of our method is evaluated and compared with other registration methods based on optimization techniques. We also compared the metrics behavior to inspect which metric is more sensitive to changes due to the presence of lung tumors

Respiratory motion correction techniques in positron emission tomography/computed tomography (PET/CT) imaging

The aim of this thesis is to design, implement, and evaluate respiratory motion correction techniques that can overcome respiratory motion artifacts in PET/CT imaging. The thesis is composed of three main sections. The first section introduces a novel approach (free-breathing amplitude gating (FBAG) technique) to correct for respiratory motion artifacts. This approach is based on sorting the acquired PET data in multiple amplitude bins which is currently not possible on any commercial PET/CT scanner. The second section is focused on the hardware/software design of an in-house respiratory gating device that is necessary to facilitate the implementation of the FBAG technique. Currently there are no commercially available respiratory gating systems that can generate the necessary triggers required for the FBAG technique. The third section is focused on developing a joint correction technique that can simultaneously suppress respiratory motion artifacts as well as partial volume effects (PVE) which represent another source of image degradation in PET/CT imaging. Computer simulations, phantom studies, as well as patient studies are conducted to test the performance of these proposed techniques and their results are shown in this thesis

Image texture analysis of transvaginal ultrasound in monitoring ovarian cancer

Ovarian cancer has the highest mortality rate of all gynaecologic cancers and is the fifth most common cancer in UK women. It has been dubbed “the silent killer” because of its non-specific symptoms. Amongst various imaging modalities, ultrasound is considered the main modality for ovarian cancer triage. Like other imaging modalities, the main issue is that the interpretation of the images is subjective and observer dependent. In order to overcome this problem, texture analysis was considered for this study. Advances in medical imaging, computer technology and image processing have collectively ramped up the interest of many researchers in texture analysis. While there have been a number of successful uses of texture analysis technique reported, to my knowledge, until recently it has yet to be applied to characterise an ovarian lesion from a B-mode image. The concept of applying texture analysis in the medical field would not replace the conventional method of interpreting images but is simply intended to aid clinicians in making their diagnoses. Five categories of textural features were considered in this study: grey-level co-occurrence matrix (GLCM), Run Length Matrix (RLM), gradient, auto-regressive (AR) and wavelet. Prior to the image classification, the robustness or how well a specific textural feature can tolerate variation arises from the image acquisition and texture extraction process was first evaluated. This includes random variation caused by the ultrasound system and the operator during image acquisition. Other factors include the influence of region of interest (ROI) size, ROI depth, scanner gain setting, and „calliper line‟. Evaluation of scanning reliability was carried out using a tissue-equivalent phantom as well as evaluations of a clinical environment. iii Additionally, the reliability of the ROI delineation procedure for clinical images was also evaluated. An image enhancement technique and semi-automatic segmentation tool were employed in order to improve the ROI delineation procedure. The results of the study indicated that two out of five textural features, GLCM and wavelet, were robust. Hence, these two features were then used for image classification purposes. To extract textural features from the clinical images, two ROI delineation approaches were introduced: (i) the textural features were extracted from the whole area of the tissue of interest, and (ii) the anechoic area within the normal and malignant tissues was excluded from features extraction. The results revealed that the second approach outperformed the first approach: there is a significant difference in the GLCM and wavelet features between the three groups: normal tissue, cysts, and malignant. Receiver operating characteristic (ROC) curve analysis was carried out to determine the discriminatory ability of textural features, which was found to be satisfactory. The principal conclusion was that GLCM and wavelet features can potentially be used as computer aided diagnosis (CAD) tools to help clinicians in the diagnosis of ovarian cancer

Mise en place d'une chaîne complète d'analyse de l'arbre trachéo-bronchique à partir d'examen(s) issus d'un scanner-CT (de la 3D vers la 4D)

Afin de répondre au problème de santé publique que représente l'asthme, l'imagerie tomodensitométrique associé aux traitements informatiques permettent la quantification et le suivi des dommages subis par les bronches. Le but de l'imagerie bronchique, lors d'un examen de type scanner-CT est de disposer de mesures fiables et reproductibles des différents paramètres bronchiques qui sont des marqueurs de l'importance de la pathologie et de son évolution sous traitements. Ces marqueurs correspondent à deux mesures LA ( Lumen Area) et WA ( Wall Area) prises sur des coupes perpendiculaires à la bronche. La mise en place d'une chaîne de traitements constitué de maillons d'extraction et de squelettisation de l'arbre trachéo-bronchique permet l'obtention de tels mesures. Durant cette thèse nous nous sommes focalisés sur la création d'une chaîne de traitements en proposant une contribution sur chacun des maillons. Notre chaîne est modulable et adaptée au travail en 4D (différentes phases respiratoires) et à fait l'objet d'une implémentation logiciel intitulée Neko4D.[Abstract not provided]BORDEAUX1-Bib.electronique (335229901) / SudocSudocFranceF

Development of computer-based algorithms for unsupervised assessment of radiotherapy contouring

INTRODUCTION: Despite the advances in radiotherapy treatment delivery, target volume delineation remains one of the greatest sources of error in the radiotherapy delivery process, which can lead to poor tumour control probability and impact clinical outcome. Contouring assessments are performed to ensure high quality of target volume definition in clinical trials but this can be subjective and labour-intensive. This project addresses the hypothesis that computational segmentation techniques, with a given prior, can be used to develop an image-based tumour delineation process for contour assessments. This thesis focuses on the exploration of the segmentation techniques to develop an automated method for generating reference delineations in the setting of advanced lung cancer. The novelty of this project is in the use of the initial clinician outline as a prior for image segmentation. METHODS: Automated segmentation processes were developed for stage II and III non-small cell lung cancer using the IDEAL-CRT clinical trial dataset. Marker-controlled watershed segmentation, two active contour approaches (edge- and region-based) and graph-cut applied on superpixels were explored. k-nearest neighbour (k-NN) classification of tumour from normal tissues based on texture features was also investigated. RESULTS: 63 cases were used for development and training. Segmentation and classification performance were evaluated on an independent test set of 16 cases. Edge-based active contour segmentation achieved highest Dice similarity coefficient of 0.80 ± 0.06, followed by graphcut at 0.76 ± 0.06, watershed at 0.72 ± 0.08 and region-based active contour at 0.71 ± 0.07, with mean computational times of 192 ± 102 sec, 834 ± 438 sec, 21 ± 5 sec and 45 ± 18 sec per case respectively. Errors in accuracy of irregularly shaped lesions and segmentation leakages at the mediastinum were observed. In the distinction of tumour and non-tumour regions, misclassification errors of 14.5% and 15.5% were achieved using 16- and 8-pixel regions of interest (ROIs) respectively. Higher misclassification errors of 24.7% and 26.9% for 16- and 8-pixel ROIs were obtained in the analysis of the tumour boundary. CONCLUSIONS: Conventional image-based segmentation techniques with the application of priors are useful in automatic segmentation of tumours, although further developments are required to improve their performance. Texture classification can be useful in distinguishing tumour from non-tumour tissue, but the segmentation task at the tumour boundary is more difficult. Future work with deep-learning segmentation approaches need to be explored.Funded by National Radiotherapy Trials Quality Assurance (RTTQA) grou