Quality assurance of organs-at-risk delineation in radiotherapy
This work addresses the unmet clinical need for automated quality assurance in radiotherapy segmentation, potentially reducing physician workload, though it is incremental as it builds on existing methods for a specific domain.
The paper tackled the problem of quality assurance for automatic segmentation of organs-at-risk in radiotherapy by proposing a one-class classifier with a residual network and attention mechanism, achieving high accuracy in detecting contour errors and outperforming binary classifiers in metrics like balanced accuracy and AUC.
The delineation of tumor target and organs-at-risk is critical in the radiotherapy treatment planning. Automatic segmentation can be used to reduce the physician workload and improve the consistency. However, the quality assurance of the automatic segmentation is still an unmet need in clinical practice. The patient data used in our study was a standardized dataset from AAPM Thoracic Auto-Segmentation Challenge. The OARs included were left and right lungs, heart, esophagus, and spinal cord. Two groups of OARs were generated, the benchmark dataset manually contoured by experienced physicians and the test dataset automatically created using a software AccuContour. A resnet-152 network was performed as feature extractor, and one-class support vector classifier was used to determine the high or low quality. We evaluate the model performance with balanced accuracy, F-score, sensitivity, specificity and the area under the receiving operator characteristic curve. We randomly generated contour errors to assess the generalization of our method, explored the detection limit, and evaluated the correlations between detection limit and various metrics such as volume, Dice similarity coefficient, Hausdorff distance, and mean surface distance. The proposed one-class classifier outperformed in metrics such as balanced accuracy, AUC, and others. The proposed method showed significant improvement over binary classifiers in handling various types of errors. Our proposed model, which introduces residual network and attention mechanism in the one-class classification framework, was able to detect the various types of OAR contour errors with high accuracy. The proposed method can significantly reduce the burden of physician review for contour delineation.