Atlas-based auto-segmentation for delineating the heart and cardiac substructures in breast cancer radiation therapy

Authors

  • Marie Louise H. Milo Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark
  • Tine B. Nyeng Department of Medical Physics, Aarhus University Hospital, Aarhus, Denmark
  • Ebbe L. Lorenzen Laboratory of Radiation Physics, Odense University Hospital, Odense, Denmark
  • Lone Hoffmann Department of Medical Physics, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Faculty of Health Sciences, Aarhus University, Denmark
  • Ditte S. Møller Department of Medical Physics, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Faculty of Health Sciences, Aarhus University, Denmark
  • Birgitte V. Offersen Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark; Danish Centre for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark; Department of Oncology, Aarhus University Hospital, Aarhus, Denmark

DOI:

https://doi.org/10.1080/0284186X.2021.1967445

Keywords:

Atlas based auto-segmentation, cardiac substructures, breast cancer, radiation therapy

Abstract

Background

This study aimed to develop and validate an automatic multi-atlas segmentation method for delineating the heart and substructures in breast cancer radiation therapy (RT).

Material and methods

The atlas database consisted of non-contrast-enhanced planning CT scans from 42 breast cancer patients, each with one manual delineation of the heart and 22 cardiac substructures. Half of the patients were scanned during free-breathing, the rest were scanned during a deep inspiration breath-hold. The auto-segmentation was developed in the MIM software system and validated geometrically and dosimetrically in two steps: The first validation in a small dataset to ensure consistency of the atlas. This was succeeded by a final test where multiple manual delineations in CT scans of 12 breast cancer patients were compared to the auto-segmentation. For geometric evaluation, the dice similarity coefficient (DSC) and the mean surface distance (MSD) were used. For dosimetric evaluation, the RT doses to each substructure in the manual and the automatic delineations were compared.

Results

In the first validation, a high geometric and dosimetric performance between the automatic and manual delineations was observed for all substructures. The final test confirmed a high agreement between the automatic and manual delineations for the heart (DSC = 0.94) and the cardiac chambers (DSC: 0.75–0.86). The difference in MSD between the automatic and manual delineations was low (<4 mm) in all structures. Finally, a high correlation between mean RT doses for the automatic and the manual delineations was observed for the heart and substructures.

Conclusions

An automatic segmentation tool for delineation of the heart and substructures in breast cancer RT was developed and validated with a high correlation between the automatic and manual delineations. The atlas is pivotal for large-scale evaluations of radiation-associated heart disease.

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Published

2022-02-01

How to Cite

Louise H. Milo, M., Nyeng, T. B., Lorenzen, E. L., Hoffmann, L., Møller, D. S., & Offersen, B. V. (2022). Atlas-based auto-segmentation for delineating the heart and cardiac substructures in breast cancer radiation therapy. Acta Oncologica, 61(2), 247–254. https://doi.org/10.1080/0284186X.2021.1967445

Issue

Vol. 61 No. 2 (2022): Acta Oncologica

Section

Articles