Cheng Boon

David Gillespie, Connah Kendrick, Ian Boon et al.

Prostate radiotherapy is a well established curative oncology modality, which in future will use Magnetic Resonance Imaging (MRI)-based radiotherapy for daily adaptive radiotherapy target definition. However the time needed to delineate the prostate from MRI data accurately is a time consuming process. Deep learning has been identified as a potential new technology for the delivery of precision radiotherapy in prostate cancer, where accurate prostate segmentation helps in cancer detection and therapy. However, the trained models can be limited in their application to clinical setting due to different acquisition protocols, limited publicly available datasets, where the size of the datasets are relatively small. Therefore, to explore the field of prostate segmentation and to discover a generalisable solution, we review the state-of-the-art deep learning algorithms in MR prostate segmentation; provide insights to the field by discussing their limitations and strengths; and propose an optimised 2D U-Net for MR prostate segmentation. We evaluate the performance on four publicly available datasets using Dice Similarity Coefficient (DSC) as performance metric. Our experiments include within dataset evaluation and cross-dataset evaluation. The best result is achieved by composite evaluation (DSC of 0.9427 on Decathlon test set) and the poorest result is achieved by cross-dataset evaluation (DSC of 0.5892, Prostate X training set, Promise 12 testing set). We outline the challenges and provide recommendations for future work. Our research provides a new perspective to MR prostate segmentation and more importantly, we provide standardised experiment settings for researchers to evaluate their algorithms. Our code is available at https://github.com/AIEMMU/MRI\_Prostate.

Stanislav Nikolov, Sam Blackwell, Alexei Zverovitch et al.

Over half a million individuals are diagnosed with head and neck cancer each year worldwide. Radiotherapy is an important curative treatment for this disease, but it requires manual time consuming delineation of radio-sensitive organs at risk (OARs). This planning process can delay treatment, while also introducing inter-operator variability with resulting downstream radiation dose differences. While auto-segmentation algorithms offer a potentially time-saving solution, the challenges in defining, quantifying and achieving expert performance remain. Adopting a deep learning approach, we demonstrate a 3D U-Net architecture that achieves expert-level performance in delineating 21 distinct head and neck OARs commonly segmented in clinical practice. The model was trained on a dataset of 663 deidentified computed tomography (CT) scans acquired in routine clinical practice and with both segmentations taken from clinical practice and segmentations created by experienced radiographers as part of this research, all in accordance with consensus OAR definitions. We demonstrate the model's clinical applicability by assessing its performance on a test set of 21 CT scans from clinical practice, each with the 21 OARs segmented by two independent experts. We also introduce surface Dice similarity coefficient (surface DSC), a new metric for the comparison of organ delineation, to quantify deviation between OAR surface contours rather than volumes, better reflecting the clinical task of correcting errors in the automated organ segmentations. The model's generalisability is then demonstrated on two distinct open source datasets, reflecting different centres and countries to model training. With appropriate validation studies and regulatory approvals, this system could improve the efficiency, consistency, and safety of radiotherapy pathways.