论文标题
淋巴结总肿瘤体积检测和通过基于距离的门控在放射疗法中使用3D CT/PET成像进行分割
Lymph Node Gross Tumor Volume Detection and Segmentation via Distance-based Gating using 3D CT/PET Imaging in Radiotherapy
论文作者
论文摘要
从3D多模式成像中发现,识别和分割可疑癌症转移淋巴结是至关重要的临床任务。在放射疗法中,它们被称为淋巴结总肿瘤体积(GTVLN)。确定和描述GTVLN的传播对于定义相应的切除和照射区域至关重要,以便为各种癌症的手术切除和放射疗法的下游工作流程。在这项工作中,我们提出了一种有效的基于距离的门控方法,以模拟和简化辐射肿瘤学家进行的高级推理方案,并以分裂和混合方式进行。通过二进制或软距离门控,分别将GTVLN分别分为两个肿瘤 - 蛋白 - 肿瘤偏见的亚组。这是由于观察到每个类别的外观,大小和其他LN特征的重叠分布的动机。每个分支机构都专门学习一个GTVLN类别特征,对每个分支进行了训练,对一个新型的多分支检测网络进行了培训,并且来自多支分支的输出融合了推理。该方法在$ 141 $的食管癌患者和CT成像方式的内部数据集上进行评估。与以前的最新作品相比,我们的结果证明了平均召回率从72.5美元\%$降至78.2 \%$的显着改善。 $ 20 \%$ precision $ 82.5 \%$ $ 82.5 \%$的最高成绩是临床相关和有价值的,因为人类观察者往往具有低灵敏度(根据文献报道,最有经验的放射线肿瘤学家的$ 80 \%$ $)。
Finding, identifying and segmenting suspicious cancer metastasized lymph nodes from 3D multi-modality imaging is a clinical task of paramount importance. In radiotherapy, they are referred to as Lymph Node Gross Tumor Volume (GTVLN). Determining and delineating the spread of GTVLN is essential in defining the corresponding resection and irradiating regions for the downstream workflows of surgical resection and radiotherapy of various cancers. In this work, we propose an effective distance-based gating approach to simulate and simplify the high-level reasoning protocols conducted by radiation oncologists, in a divide-and-conquer manner. GTVLN is divided into two subgroups of tumor-proximal and tumor-distal, respectively, by means of binary or soft distance gating. This is motivated by the observation that each category can have distinct though overlapping distributions of appearance, size and other LN characteristics. A novel multi-branch detection-by-segmentation network is trained with each branch specializing on learning one GTVLN category features, and outputs from multi-branch are fused in inference. The proposed method is evaluated on an in-house dataset of $141$ esophageal cancer patients with both PET and CT imaging modalities. Our results validate significant improvements on the mean recall from $72.5\%$ to $78.2\%$, as compared to previous state-of-the-art work. The highest achieved GTVLN recall of $82.5\%$ at $20\%$ precision is clinically relevant and valuable since human observers tend to have low sensitivity (around $80\%$ for the most experienced radiation oncologists, as reported by literature).