Si-Yuan Zhang

Navdeep Dahiya, Sadegh R Alam, Pengpeng Zhang et al.

In current clinical practice, noisy and artifact-ridden weekly cone-beam computed tomography (CBCT) images are only used for patient setup during radiotherapy. Treatment planning is done once at the beginning of the treatment using high-quality planning CT (pCT) images and manual contours for organs-at-risk (OARs) structures. If the quality of the weekly CBCT images can be improved while simultaneously segmenting OAR structures, this can provide critical information for adapting radiotherapy mid-treatment as well as for deriving biomarkers for treatment response. Using a novel physics-based data augmentation strategy, we synthesize a large dataset of perfectly/inherently registered planning CT and synthetic-CBCT pairs for locally advanced lung cancer patient cohort, which are then used in a multitask 3D deep learning framework to simultaneously segment and translate real weekly CBCT images to high-quality planning CT-like images. We compared the synthetic CT and OAR segmentations generated by the model to real planning CT and manual OAR segmentations and showed promising results. The real week 1 (baseline) CBCT images which had an average MAE of 162.77 HU compared to pCT images are translated to synthetic CT images that exhibit a drastically improved average MAE of 29.31 HU and average structural similarity of 92% with the pCT images. The average DICE scores of the 3D organs-at-risk segmentations are: lungs 0.96, heart 0.88, spinal cord 0.83 and esophagus 0.66. This approach could allow clinicians to adjust treatment plans using only the routine low-quality CBCT images, potentially improving patient outcomes. Our code, data, and pre-trained models will be made available via our physics-based data augmentation library, Physics-ArX, at https://github.com/nadeemlab/Physics-ArX.

Sadegh R Alam, Tianfang Li, Pengpeng Zhang et al.

Automated segmentation of esophagus is critical in image guided/adaptive radiotherapy of lung cancer to minimize radiation-induced toxicities such as acute esophagitis. We developed a semantic physics-based data augmentation method for segmenting esophagus in both planning CT (pCT) and cone-beam CT (CBCT) using 3D convolutional neural networks. 191 cases with their pCT and CBCTs from four independent datasets were used to train a modified 3D-Unet architecture with a multi-objective loss function specifically designed for soft-tissue organs such as esophagus. Scatter artifacts and noise were extracted from week 1 CBCTs using power law adaptive histogram equalization method and induced to the corresponding pCT followed by reconstruction using CBCT reconstruction parameters. Moreover, we leverage physics-based artifact induced pCTs to drive the esophagus segmentation in real weekly CBCTs. Segmentations were evaluated using geometric Dice and Hausdorff distance as well as dosimetrically using mean esophagus dose and D5cc. Due to the physics-based data augmentation, our model trained just on the synthetic CBCTs was robust and generalizable enough to also produce state-of-the-art results on the pCTs and CBCTs, achieving 0.81 and 0.74 Dice overlap. Our physics-based data augmentation spans the realistic noise/artifact spectrum across patient CBCT/pCT data and can generalize well across modalities with the potential to improve the accuracy of treatment setup and response analysis.