Automatic contouring system for cervical cancer using convolutional neural networks

• DOI: 10.1002/mp.14467
• Publication Date: 2020-09-23T01:16:15Z
• Authors: Dong Joo Rhee; Anuja Jhingran; Bastien Rigaud; Tucker Netherton; Carlos E. Cardenas; Lifei Zhang; Sastry Vedam; Stephen Kry; Kristy K. Brock; William Shaw; Frederika O’Reilly; Jeannette Parkes; Hester Burger; Nazia Fakie; Chris Trauernicht; Hannah Simonds; Laurence E. Court
• Keywords: Organs at Risk; 03 medical and health sciences; 0302 clinical medicine; Radiotherapy Planning, Computer-Assisted; QUANTITATIVE IMAGING AND IMAGE PROCESSING; Humans; Uterine Cervical Neoplasms; Female; Neural Networks, Computer; Retrospective Studies; 3. Good health

PurposeTo develop a tool for the automatic contouring of clinical treatment volumes (CTVs) and normal tissues for radiotherapy treatment planning in cervical cancer patients.MethodsAn auto‐contouring tool based on convolutional neural networks (CNN) was developed to delineate three cervical CTVs and 11 normal structures (seven OARs, four bony structures) in cervical cancer treatment for use with the Radiation Planning Assistant, a web‐based automatic plan generation system. A total of 2254 retrospective clinical computed tomography (CT) scans from a single cancer center and 210 CT scans from a segmentation challenge were used to train and validate the CNN‐based auto‐contouring tool. The accuracy of the tool was evaluated by calculating the Sørensen‐dice similarity coefficient (DSC) and mean surface and Hausdorff distances between the automatically generated contours and physician‐drawn contours on 140 internal CT scans. A radiation oncologist scored the automatically generated contours on 30 external CT scans from three South African hospitals.ResultsThe average DSC, mean surface distance, and Hausdorff distance of our CNN‐based tool were 0.86/0.19 cm/2.02 cm for the primary CTV, 0.81/0.21 cm/2.09 cm for the nodal CTV, 0.76/0.27 cm/2.00 cm for the PAN CTV, 0.89/0.11 cm/1.07 cm for the bladder, 0.81/0.18 cm/1.66 cm for the rectum, 0.90/0.06 cm/0.65 cm for the spinal cord, 0.94/0.06 cm/0.60 cm for the left femur, 0.93/0.07 cm/0.66 cm for the right femur, 0.94/0.08 cm/0.76 cm for the left kidney, 0.95/0.07 cm/0.84 cm for the right kidney, 0.93/0.05 cm/1.06 cm for the pelvic bone, 0.91/0.07 cm/1.25 cm for the sacrum, 0.91/0.07 cm/0.53 cm for the L4 vertebral body, and 0.90/0.08 cm/0.68 cm for the L5 vertebral bodies. On average, 80% of the CTVs, 97% of the organ at risk, and 98% of the bony structure contours in the external test dataset were clinically acceptable based on physician review.ConclusionsOur CNN‐based auto‐contouring tool performed well on both internal and external datasets and had a high rate of clinical acceptability.