Affiliation:
1. Division of Abdominal Tumor Multimodality Treatment Department of Radiation Oncology Cancer Center West China Hospital, Sichuan University Chengdu China
2. Med‐X Center for Informatics Sichuan University Chengdu China
3. Lung Cancer Center West China Hospital, Sichuan University Chengdu China
4. Chengdu Institute of Compute Application Chinese Academy of Sciences Chengdu China
Abstract
AbstractBackgroundWhile there are established international consensuses on the delineation of pelvic lymph node regions (LNRs), significant inter‐ and intra‐observer variabilities persist. Contouring these clinical target volumes for irradiation in pelvic malignancies is both time‐consuming and labor‐intensive.PurposeThe purpose of this study was to develop a deep learning model of pelvic LNRs delineation for patients with pelvic cancers.MethodsPlanning computed tomography (CT) studies of 160 patients with pelvic primary malignancies (including rectal, prostate, and cervical cancer) were retrospectively collected and divided into training set (n = 120) and testing set (n = 40). Six pelvic LNRs, including abdominal presacral, pelvic presacral, internal iliac nodes, external iliac nodes, obturator nodes, and inguinal nodes were delineated by two radiation oncologists as ground truth (Gt) contours. The cascaded multi‐heads U‐net (CMU‐net) was constructed based on the Gt contours from training cohort, which was subsequently verified in the testing cohort. The automatic delineation of six LNRs (Auto) was evaluated using dice similarity coefficient (DSC), average surface distance (ASD), 95th percentile Hausdorff distance (HD95), and a 7‐point scale score.ResultsIn the testing set, the DSC of six pelvic LNRs by CMU‐net model varied from 0.851 to 0.942, ASD from 0.381 to 1.037 mm, and HD95 from 2.025 to 3.697 mm. No significant differences were founded in these three parameters between postoperative and preoperative cases. 95.9% and 96.2% of auto delineations by CMU‐net model got a score of 1–3 by two expert radiation oncologists, respectively, meaning only minor edits needed.ConclusionsThe CMU‐net was successfully developed for automated delineation of pelvic LNRs for pelvic malignancies radiotherapy with improved contouring efficiency and highly consistent, which might justify its implementation in radiotherapy work flow.