Dirk J. Grunhagen

Douwe J. Spaanderman, Martijn P. A. Starmans, Gonnie C. M. van Erp et al.

Segmentations are crucial in medical imaging to obtain morphological, volumetric, and radiomics biomarkers. Manual segmentation is accurate but not feasible in the radiologist's clinical workflow, while automatic segmentation generally obtains sub-par performance. We therefore developed a minimally interactive deep learning-based segmentation method for soft-tissue tumors (STTs) on CT and MRI. The method requires the user to click six points near the tumor's extreme boundaries. These six points are transformed into a distance map and serve, with the image, as input for a Convolutional Neural Network. For training and validation, a multicenter dataset containing 514 patients and nine STT types in seven anatomical locations was used, resulting in a Dice Similarity Coefficient (DSC) of 0.85$\pm$0.11 (mean $\pm$ standard deviation (SD)) for CT and 0.84$\pm$0.12 for T1-weighted MRI, when compared to manual segmentations made by expert radiologists. Next, the method was externally validated on a dataset including five unseen STT phenotypes in extremities, achieving 0.81$\pm$0.08 for CT, 0.84$\pm$0.09 for T1-weighted MRI, and 0.88\pm0.08 for previously unseen T2-weighted fat-saturated (FS) MRI. In conclusion, our minimally interactive segmentation method effectively segments different types of STTs on CT and MRI, with robust generalization to previously unseen phenotypes and imaging modalities.

Martijn P. A. Starmans, Sebastian R. van der Voort, Thomas Phil et al.

Predicting clinical outcomes from medical images using quantitative features (``radiomics'') requires many method design choices, Currently, in new clinical applications, finding the optimal radiomics method out of the wide range of methods relies on a manual, heuristic trial-and-error process. We introduce a novel automated framework that optimizes radiomics workflow construction per application by standardizing the radiomics workflow in modular components, including a large collection of algorithms for each component, and formulating a combined algorithm selection and hyperparameter optimization problem. To solve it, we employ automated machine learning through two strategies (random search and Bayesian optimization) and three ensembling approaches. Results show that a medium-sized random search and straight-forward ensembling perform similar to more advanced methods while being more efficient. Validated across twelve clinical applications, our approach outperforms both a radiomics baseline and human experts. Concluding, our framework improves and streamlines radiomics research by fully automatically optimizing radiomics workflow construction. To facilitate reproducibility, we publicly release six datasets, software of the method, and code to reproduce this study.