Automated deep learning-based segmentation of COVID-19 lesions from chest computed tomography images

Purpose: The novel coronavirus COVID-19, which spread globally in late December 2019, is a global health crisis. Chest computed tomography (CT) has played a pivotal role in providing useful information for clinicians to detect COVID-19. However, segmenting COVID-19-infected regions from chest CT results is challenging. Therefore, it is desirable to develop an efficient tool for automated segmentation of COVID-19 lesions using chest CT. Hence, we aimed to propose 2D deep-learning algorithms to automatically segment COVID-19-infected regions from chest CT slices and evaluate their performance. Material and methods: Herein, 3 known deep learning networks: U-Net, U-Net++, and Res-Unet, were trained from scratch for automated segmenting of COVID-19 lesions using chest CT images. The dataset consists of 20 labelled COVID-19 chest CT volumes. A total of 2112 images were used. The dataset was split into 80% for training and validation and 20% for testing the proposed models. Segmentation performance was assessed using Dice similarity coefficient, average symmetric surface distance (ASSD), mean absolute error (MAE), sensitivity, specificity, and precision. Results: All proposed models achieved good performance for COVID-19 lesion segmentation. Compared with Res-Unet, the U-Net and U-Net++ models provided better results, with a mean Dice value of 85.0%. Compared with all models, U-Net gained the highest segmentation performance, with 86.0% sensitivity and 2.22 mm ASSD. The U-Net model obtained 1%, 2%, and 0.66 mm improvement over the Res-Unet model in the Dice, sensitivity, and ASSD, respectively. Compared with Res-Unet, U-Net++ achieved 1%, 2%, 0.1 mm, and 0.23 mm improvement in the Dice, sensitivity, ASSD, and MAE, respectively. Conclusions: Our data indicated that the proposed models achieve an average Dice value greater than 84.0%. Two-dimensional deep learning models were able to accurately segment COVID-19 lesions from chest CT images, assisting the radiologists in faster screening and quantification of the lesion regions for further treatment. Nevertheless, further studies will be required to evaluate the clinical performance and robustness of the proposed models for COVID-19 semantic segmentation

A historical literature review on the role of posterior axillary boost field in the axillary lymph node coverage and development of lymphedema following regional nodal irradiation in breast cancer

To elucidate whether (1) a posterior axillary boost (PAB) field is an optimal method to target axillary lymph nodes (LNs); and (2) the addition of a PAB increases the incidence of lymphedema, a systematic review was undertaken. A literature search was performed in the PubMed database. A total of 16 studies were evaluated. There were no randomized studies. Seven articles have investigated dosimetric aspects of a PAB. The remaining 9 articles have determined the effect of a PAB field on the risk of lymphedema. Only 2 of 9 articles have prospectively reported the impact of a PAB on the risk of lymphedema development. There are conflicting reports on the necessity of a PAB. The PAB field provides a good coverage of level I/II axillary LNs because these nodes are usually at a greater depth. The main concern regarding a PAB is that it produces a hot spot in the anterior region of the axilla. Planning studies optimized a traditional PAB field. Prospective studies and the vast majority of retrospective studies have reported the use of a PAB field does not result in increasing the risk of lymphedema development over supraclavicular-only field. The controversies in the incidence of lymphedema suggest that field design may be more important than field arrangement. A key factor regarding the use of a PAB is the depth of axillary LNs. The PAB field should not be used unless there is an absolute indication for its application. Clinicians should weigh lymphedema risk in individual patients against the limited benefit of a PAB, in particular after axillary dissection. The testing of the inclusion of upper arm lymphatics in the regional LN irradiation target volume, and universal methodology measuring lymphedema are all areas for possible future studies

Assessment of Radiographers’ Awareness about Radiation Protection Principles in Hospitals of Bandar Abbas, Iran

Introduction This study was conducted to evaluate the radiographers’ awareness of radiation protection principles in the radiology centers of the hospitals of Bandar Abbas, Iran. Materials and Methods This analytical cross-sectional study was conducted on 50 radiographers of three hospitals affiliated with Hormozgan University of Medical Sciences in 2015. The data were collected using a two-part questionnaire. The first part was related to the demographic information of the radiographers(i.e. age, gender, work experience, workplace, and passing related training courses). The second part consisted of questions related to the radiographers’ awareness in three fields of radiology physics, radiation protection, and hazards of radiation. Results According to the results of the present study, the mean total scores of the radiographers’ awareness about the radiology physics, radiation protection, and hazards of radiation was 18.41±1.14 out of 22. However, the radiographers’ awareness of the three investigated fields had no statistically significant relationships with the work experience (P=0.244) and gender (P=0.386). However, there was a significant relationship between the radiographers’ awareness about the radiation protection and their education level (P=0.034). Moreover, a significant association was found between the radiographers’ awareness and their workplace (P=0.009). Additionally, the participation in the radiation training courses was significantly correlated with the radiographers’ awareness regarding the radiation hazards (P=0.022). Conclusion According to the findings of the present study, the awareness level of the radiographers about the radiation protection principles was relatively good. However, it seems that the education level of the staff should be enhanced through holding regular short-term radiation training courses