Clinical evaluation of a deep learning segmentation model including manual adjustments afterwards for locally advanced breast cancer

Autor: Nienke Bakx, Dorien Rijkaart, Maurice van der Sangen, Jacqueline Theuws, Peter-Paul van der Toorn, An-Sofie Verrijssen, Jorien van der Leer, Joline Mutsaers, Thérèse van Nunen, Marjon Reinders, Inge Schuengel, Julia Smits, Els Hagelaar, Dave van Gruijthuijsen, Hanneke Bluemink, Coen Hurkmans
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Technical Innovations & Patient Support in Radiation Oncology, Vol 26, Iss , Pp 100211- (2023)
Druh dokumentu: article
ISSN: 2405-6324
DOI: 10.1016/j.tipsro.2023.100211
Popis: Introduction: Deep learning (DL) models are increasingly developed for auto-segmentation in radiotherapy. Qualitative analysis is of great importance for clinical implementation, next to quantitative. This study evaluates a DL segmentation model for left- and right-sided locally advanced breast cancer both quantitatively and qualitatively. Methods: For each side a DL model was trained, including primary breast CTV (CTVp), lymph node levels 1–4, heart, lungs, humeral head, thyroid and esophagus. For evaluation, both automatic segmentation, including correction of contours when needed, and manual delineation was performed and both processes were timed. Quantitative scoring with dice-similarity coefficient (DSC), 95% Hausdorff Distance (95%HD) and surface DSC (sDSC) was used to compare both the automatic (not-corrected) and corrected contours with the manual contours. Qualitative scoring was performed by five radiotherapy technologists and five radiation oncologists using a 3-point Likert scale. Results: Time reduction was achieved using auto-segmentation in 95% of the cases, including correction. The time reduction (mean ± std) was 42.4% ± 26.5% and 58.5% ± 19.1% for OARs and CTVs, respectively, corresponding to an absolute mean reduction (hh:mm:ss) of 00:08:51 and 00:25:38. Good quantitative results were achieved before correction, e.g. mean DSC for the right-sided CTVp was 0.92 ± 0.06, whereas correction statistically significantly improved this contour by only 0.02 ± 0.05, respectively. In 92% of the cases, auto-contours were scored as clinically acceptable, with or without corrections. Conclusions: A DL segmentation model was trained and was shown to be a time-efficient way to generate clinically acceptable contours for locally advanced breast cancer.
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