Segmentation of Planning Target Volume in CT Series for Total Marrow Irradiation Using U-Net
This addresses the problem of reducing manual workload for radiation oncologists in cancer radiotherapy planning, though it is incremental as it applies an existing deep learning method to a specific medical domain.
The paper tackled the time-consuming manual segmentation of Planning Target Volume in CT scans for Total Marrow and Lymph node Irradiation by developing a U-Net-based auto-contouring method, achieving an average Dice score of 0.816 for segmentation.
Radiotherapy (RT) is a key component in the treatment of various cancers, including Acute Lymphocytic Leukemia (ALL) and Acute Myelogenous Leukemia (AML). Precise delineation of organs at risk (OARs) and target areas is essential for effective treatment planning. Intensity Modulated Radiotherapy (IMRT) techniques, such as Total Marrow Irradiation (TMI) and Total Marrow and Lymph node Irradiation (TMLI), provide more precise radiation delivery compared to Total Body Irradiation (TBI). However, these techniques require time-consuming manual segmentation of structures in Computerized Tomography (CT) scans by the Radiation Oncologist (RO). In this paper, we present a deep learning-based auto-contouring method for segmenting Planning Target Volume (PTV) for TMLI treatment using the U-Net architecture. We trained and compared two segmentation models with two different loss functions on a dataset of 100 patients treated with TMLI at the Humanitas Research Hospital between 2011 and 2021. Despite challenges in lymph node areas, the best model achieved an average Dice score of 0.816 for PTV segmentation. Our findings are a preliminary but significant step towards developing a segmentation model that has the potential to save radiation oncologists a considerable amount of time. This could allow for the treatment of more patients, resulting in improved clinical practice efficiency and more reproducible contours.