Comprehensive and Clinically Accurate Head and Neck Organs at Risk Delineation via Stratified Deep Learning: A Large-scale Multi-Institutional Study
PAII Inc.（PAII公司）；The First Affiliated Hospital Zhejiang University（浙江大学附属第一医院）；Ping An Technology（平安科技）；Chang Gung Memorial Hospital（长庚纪念医院）；Johns Hopkins University（约翰斯·霍普金斯大学）；Huadong Hospital Affiliated to Fudan University（复旦大学附属华东医院）；First Affiliated Hospital of Xi'an Jiaotong University（西安交通大学第一附属医院）；People's Hospital of Shanxi Province（山西省人民医院）；Nanfang Hospital, Southern Medical University（南方医科大学南方医院）；The First Hospital of Lanzhou University（兰州大学第一医院）；Chang Gung University（长庚大学）
Dazhou Guo, Jia Ge, Xianghua Ye, Senxiang Yan, Yi Xin, Yuchen Song, Bing-shen Huang, Tsung-Min Hung, Zhuotun Zhu, Ling Peng, Yanping Ren, Rui Liu, Gong Zhang, M… 展开作者
Dazhou Guo, Jia Ge, Xianghua Ye, Senxiang Yan, Yi Xin, Yuchen Song, Bing-shen Huang, Tsung-Min Hung, Zhuotun Zhu, Ling Peng, Yanping Ren, Rui Liu, Gong Zhang, Mengyuan Mao, Xiaohua Chen, Zhongjie Lu, Wenxiang Li, Yuzhen Chen, Lingyun Huang, Jing Xiao, Adam P. Harrison, Le Lu, Chien-Yu Lin, Dakai Jin, Tsung-Ying Ho
Accurate organ at risk (OAR) segmentation is critical to reduce the radiotherapy post-treatment complications. Consensus guidelines recommend a set of more than 40 OARs in the head and neck (H&N) region, however, due to the predictable prohibitive labor-cost of this task, most institutions choose a substantially simplified protocol by delineating a smaller subset of OARs and neglecting the dose distributions associated with other OARs. In this work we propose a novel, automated and highly effective stratified OAR segmentation (SOARS) system using deep learning to precisely delineate a comprehensive set of 42 H&N OARs. SOARS stratifies 42 OARs into anchor, mid-level, and small & hard subcategories, with specifically derived neural network architectures for each category by neural architecture search (NAS) principles. We built SOARS models using 176 training patients in an internal institution and independently evaluated on 1327 external patients across six different institutions. It consistently outperformed other state-of-the-art methods by at least 3-5% in Dice score for each institutional evaluation (up to 36% relative error reduction in other metrics). More importantly, extensive multi-user studies evidently demonstrated that 98% of the SOARS predictions need only very minor or no revisions for direct clinical acceptance (saving 90% radiation oncologists workload), and their segmentation and dosimetric accuracy are within or smaller than the inter-user variation. These findings confirmed the strong clinical applicability of SOARS for the OAR delineation process in H&N cancer radiotherapy workflows, with improved efficiency, comprehensiveness, and quality.
University of North Carolina at Chapel Hill（北卡罗来纳大学教堂山分校）
The accurate segmentation of organs-at-risk (OARs) in head and neck CT images is a critical step for radiation therapy of head and neck cancer patients. However, manual delineation for numerous OARs is time-consuming and laborious, even for expert oncologists. Moreover, manual delineation results are susceptible to high intra- and inter-variability. To this end, we propose a novel dual shape guided network (DSGnet) to automatically delineate nine important OARs in head and neck CT images. To deal with the large shape variation and unclear boundary of OARs in CT images, we represent the organ s…
LaTIM, INSERM, UMR 1101, University Brest（拉蒂姆研究所、法国国家健康与医学研究院、布雷斯特大学）
Development of robust and accurate fully automated methods for medical image segmentation is crucial in clinical practice and radiomics studies. In this work, we contributed an automated approach for Head and Neck (H&N) primary tumor segmentation in combined positron emission tomography / computed tomography (PET/CT) images in the context of the MICCAI 2020 Head and Neck Tumor segmentation challenge (HECKTOR). Our model was designed on the U-Net architecture with residual layers and supplemented with Squeeze-and-Excitation Normalization. The described method achieved competitive results in cro…
DeepVoxel Inc（深体素公司）；Shanghai General Hospital（上海市第一人民医院）；Shanghai Jiao Tong University School of Medicine（上海交通大学医学院）；University of California, Irvine（加州大学欧文分校）
Organs-at-risk (OAR) delineation in computed tomography (CT) is an important step in Radiation Therapy (RT) planning. Recently, deep learning based methods for OAR delineation have been proposed and applied in clinical practice for separate regions of the human body (head and neck, thorax, and abdomen). However, there are few researches regarding the end-to-end whole-body OARs delineation because the existing datasets are mostly partially or incompletely annotated for such task. In this paper, our proposed end-to-end convolutional neural network model, called \textbf{AttentionAnatomy}, can be …
Purpose: Organ-at-risk (OAR) delineation is a key step for cone-beam CT (CBCT) based adaptive radiotherapy planning that can be a time-consuming, labor-intensive, and subject-to-variability process. We aim to develop a fully automated approach aided by synthetic MRI for rapid and accurate CBCT multi-organ contouring in head-and-neck (HN) cancer patients. MRI has superb soft-tissue contrasts, while CBCT offers bony-structure contrasts. Using the complementary information provided by MRI and CBCT is expected to enable accurate multi-organ segmentation in HN cancer patients. In our proposed metho…
A 3D deep learning model (OARnet) is developed and used to delineate 28 H&N OARs on CT images. OARnet utilizes a densely connected network to detect the OAR bounding-box, then delineates the OAR within the box. It reuses information from any layer to subsequent layers and uses skip connections to combine information from different dense block levels to progressively improve delineation accuracy. Training uses up to 28 expert manual delineated (MD) OARs from 165 CTs. Dice similarity coefficient (DSC) and the 95th percentile Hausdorff distance (HD95) with respect to MD is assessed for 70 other C…
PAII Inc.（PAII公司）；Chang Gung Memorial Hospital（长庚纪念医院）；The Johns Hopkins University（约翰斯·霍普金斯大学）；National Tsing Hua University（国立清华大学）；Ping An Technology（平安科技）
OAR segmentation is a critical step in radiotherapy of head and neck (H&N) cancer, where inconsistencies across radiation oncologists and prohibitive labor costs motivate automated approaches. However, leading methods using standard fully convolutional network workflows that are challenged when the number of OARs becomes large, e.g. > 40. For such scenarios, insights can be gained from the stratification approaches seen in manual clinical OAR delineation. This is the goal of our work, where we introduce stratified organ at risk segmentation (SOARS), an approach that stratifies OARs into anchor…
An automatic segmentation algorithm for delineation of the gross tumour volume and pathologic lymph nodes of head and neck cancers in PET/CT images is described. The proposed algorithm is based on a convolutional neural network using the U-Net architecture. Several model hyperparameters were explored and the model performance in terms of the Dice similarity coefficient was validated on images from 15 patients. A separate test set consisting of images from 40 patients was used to assess the generalisability of the algorithm. The performance on the test set showed close-to-oncologist level delin…
Background: Deep learning (DL)-based head and neck lymph node level (HN_LNL) autodelineation is of high relevance to radiotherapy research and clinical treatment planning but still underinvestigated in academic literature. Methods: An expert-delineated cohort of 35 planning CTs was used for training of an nnU-net 3D-fullres/2D-ensemble model for autosegmentation of 20 different HN_LNL. A second cohort acquired at the same institution later in time served as the test set (n=20). In a completely blinded evaluation, 3 clinical experts rated the quality of DL autosegmentations in a head-to-head co…
Northwestern University（西北大学）；University of Chicago（芝加哥大学）
Head and Neck (H\&N) organ-at-risk (OAR) and tumor segmentations are essential components of radiation therapy planning. The varying anatomic locations and dimensions of H\&N nodal Gross Tumor Volumes (GTVn) and H\&N primary gross tumor volume (GTVp) are difficult to obtain due to lack of accurate and reliable delineation methods. The downstream effect of incorrect segmentation can result in unnecessary irradiation of normal organs. Towards a fully automated radiation therapy planning algorithm, we explore the efficacy of multi-scale fusion based deep learning architectures for accurately segm…
HEad and neCK TumOR (HECKTOR) 2025: Benchmark of Segmentation, Diagnosis, and Prognosis in Multimodal PET/CT
Mohamed bin Zayed University of Artificial Intelligence (MBZUAI)（穆罕默德·本·扎耶德人工智能大学）；Amsterdam UMC（阿姆斯特丹大学医学中心）；The Netherlands Cancer Institute（荷兰癌症研究所）；Radboud University Medical Centre（拉德堡德大学医学中心）；University College London（伦敦大学学院）；Imperial College London（帝国理工学院）；Shenzhen Technology University（深圳技术大学）；Shenzhen University（深圳大学）；Newland Digital Technology（新大陆数字技术）；The University of Sydney（悉尼大学）；Shanghai Jiao Tong University（上海交通大学）；University Hospital, Nantes（南特大学医院）；Nantes Université, Centrale Nantes, CNRS, LS2N（南特大学、南特中央理工学院、法国国家科学研究中心、LS2N实验室）；Hangzhou Dianzi University（杭州电子科技大学）；Tsinghua University（清华大学）；Central South University（中南大学）；University of Glasgow（格拉斯哥大学）；China Mobile System Integration Co., Ltd.（中移系统集成有限公司）；Subtle Medical Inc.（Subtle Medical公司）；University Hospital, LMU Munich（慕尼黑大学医院）；Munich Center for Machine Learning（慕尼黑机器学习中心）；BC Cancer Research Institute（不列颠哥伦比亚癌症研究所）；HES-SO Valais-Wallis University of Applied Sciences and Arts（HES-SO瓦莱州应用科学与艺术大学）；Lausanne University Hospital (CHUV)（洛桑大学医院）；LaTIM, INSERM, UMR 1101, Univ Brest（LaTIM实验室、法国国家健康与医学研究院、UMR 1101、布雷斯特大学）
Mixture of Multicenter Experts in Multimodal AI for Debiased Radiotherapy Target Delineation
Center for Advanced Medical Computing and Analysis (CAMCA), Department of Radiology, Massachusetts General Hospital (MGH) and Harvard Medical School（先进医学计算与分析中心（CAMCA）、放射科、麻省总医院（MGH）和哈佛医学院）；Department of Radiation Oncology, Yonsei University College of Medicine（燕京大学医学院放射肿瘤科）；Institute for Innovation in Digital Healthcare, Yonsei University（数字医疗创新研究所、燕京大学）；Department of Radiation Oncology, Massachusetts General Hospital（麻省总医院放射肿瘤科）；Department of Radiation Oncology, Gangnam Severance Hospital（江南松云医院放射肿瘤科）；Department of Radiation Oncology, Yongin Severance Hospital（永兴松云医院放射肿瘤科）；School of Computing, University of Georgia（佐治亚大学计算机学院）；Department of Radiation Oncology, Mayo Clinic（梅奥诊所放射肿瘤科）；Kim Jaechul Graduate School of AI, Korea Advanced Institute of Science and Technology（金 Jaechul人工智能研究生院、韩国科学技术院）
Cancer Hospital of University of the Chinese Academy of Sciences (Zhejiang Cancer Hospital)（中国科学院大学附属肿瘤医院（浙江省肿瘤医院））；Rutgers University（罗格斯大学）；The Chinese University of Hong Kong（香港中文大学）；SenseTime Research（商汤科技研究院）
Radiotherapy is a treatment where radiation is used to eliminate cancer cells. The delineation of organs-at-risk (OARs) is a vital step in radiotherapy treatment planning to avoid damage to healthy organs. For nasopharyngeal cancer, more than 20 OARs are needed to be precisely segmented in advance. The challenge of this task lies in complex anatomical structure, low-contrast organ contours, and the extremely imbalanced size between large and small organs. Common segmentation methods that treat them equally would generally lead to inaccurate small-organ labeling. We propose a novel two-stage de…
Dual-Reference Source-Free Active Domain Adaptation for Nasopharyngeal Carcinoma Tumor Segmentation across Multiple Hospitals
Hong Kong University of Science and Technology (Guangzhou)（香港科技大学（广州））；University of Cambridge（剑桥大学）；Anhui Provincial Hospital, University of Science and Technology of China（中国科学技术大学附属安徽省立医院）；Nanfang Hospital, Southern Medical University（南方医科大学南方医院）；Sichuan Provincial People’s Hospital（四川省人民医院）；West China Hospital, Sichuan University（四川大学华西医院）；Sichuan Cancer Hospital and Institute, University of Electronic Science and Technology of China（电子科技大学附属四川省肿瘤医院（研究所））；Shanghai Artificial Intelligence Laboratory（上海人工智能实验室）
University of Toronto（多伦多大学）；Princess Margaret Cancer Centre（玛格丽特公主癌症中心）；TECHNA Institute（TECHNA研究所）
Accurate prognosis for an individual patient is a key component of precision oncology. Recent advances in machine learning have enabled the development of models using a wider range of data, including imaging. Radiomics aims to extract quantitative predictive and prognostic biomarkers from routine medical imaging, but evidence for computed tomography radiomics for prognosis remains inconclusive. We have conducted an institutional machine learning challenge to develop an accurate model for overall survival prediction in head and neck cancer using clinical data etxracted from electronic medical …
Gamagori City Hospital（蒲郡市立医院）；Nagoya University Graduate School of Medicine（名古屋大学医学部附属研究生院）；Tsushima City Hospital（对马市立医院）；Nagoya Daini Red Cross Hospital（名古屋第二红十字医院）；Search Space CO.Ltd.（Search Space有限公司）；Nagoya Orthopedic Regional Healthcare Support Center, AI Research Division（名古屋骨科区域医疗支援中心 AI 研究部）
[Objective] To develop a Computer-aided diagnosis (CAD) system for plane frontal hip X-rays with a deep learning model trained on a large dataset collected at multiple centers. [Materials and Methods]. We included 5295 cases with neck fracture or trochanteric fracture who were diagnosed and treated by orthopedic surgeons using plane X-rays or computed tomography (CT) or magnetic resonance imaging (MRI) who visited each institution between April 2009 and March 2019 were enrolled. Cases in which both hips were not included in the photographing range, femoral shaft fractures, and periprosthetic f…
Emory University（埃默里大学）；Johns Hopkins University（约翰斯·霍普金斯大学）；Memorial Sloan Kettering Cancer Center（纪念斯隆·凯特琳癌症中心）
In this work, we propose an adversarial attack-based data augmentation method to improve the deep-learning-based segmentation algorithm for the delineation of Organs-At-Risk (OAR) in abdominal Computed Tomography (CT) to facilitate radiation therapy. We introduce Adversarial Feature Attack for Medical Image (AFA-MI) augmentation, which forces the segmentation network to learn out-of-distribution statistics and improve generalization and robustness to noises. AFA-MI augmentation consists of three steps: 1) generate adversarial noises by Fast Gradient Sign Method (FGSM) on the intermediate featu…
Adaptive radiotherapy (ART), especially online ART, effectively accounts for positioning errors and anatomical changes. One key component of online ART is accurately and efficiently delineating organs at risk (OARs) and targets on online images, such as CBCT, to meet the online demands of plan evaluation and adaptation. Deep learning (DL)-based automatic segmentation has gained great success in segmenting planning CT, but its applications to CBCT yielded inferior results due to the low image quality and limited available contour labels for training. To overcome these obstacles to online CBCT s…
