Deep learning-based auto-contouring of organs/structures-at-risk for pediatric upper abdominal radiotherapy.
Authors
Affiliations (7)
Affiliations (7)
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands; Department of Radiation Oncology, Imaging and Cancer Division, University Medical Center Utrecht, Utrecht, The Netherlands; Computational Imaging Group for MR Diagnostics & Therapy, Center for Image Sciences, University Medical Center Utrecht, Utrecht, The Netherlands.
- Department of Radiation Oncology, Imaging and Cancer Division, University Medical Center Utrecht, Utrecht, The Netherlands; Computational Imaging Group for MR Diagnostics & Therapy, Center for Image Sciences, University Medical Center Utrecht, Utrecht, The Netherlands.
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands; Department of Radiation Oncology, Imaging and Cancer Division, University Medical Center Utrecht, Utrecht, The Netherlands.
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands; Division Imaging & Cancer, University Medical Center Utrecht, Utrecht, The Netherlands.
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands; Child Health Program, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands.
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands; Department of Radiation Oncology, Imaging and Cancer Division, University Medical Center Utrecht, Utrecht, The Netherlands. Electronic address: [email protected].
Abstract
This study aimed to develop a computed tomography (CT)-based multi-organ segmentation model for delineating organs-at-risk (OARs) in pediatric upper abdominal tumors and evaluate its robustness across multiple datasets. In-house postoperative CTs from pediatric patients with renal tumors and neuroblastoma (n = 189) and a public dataset (n = 189) with CTs covering thoracoabdominal regions were used. Seventeen OARs were delineated: nine by clinicians (Type 1) and eight using TotalSegmentator (Type 2). Auto-segmentation models were trained using in-house (Model-PMC-UMCU) and a combined dataset of public data (Model-Combined). Performance was assessed with Dice Similarity Coefficient (DSC), 95 % Hausdorff Distance (HD95), and mean surface distance (MSD). Two clinicians rated clinical acceptability on a 5-point Likert scale across 15 patient contours. Model robustness was evaluated against sex, age, intravenous contrast, and tumor type. Model-PMC-UMCU achieved mean DSC values above 0.95 for five of nine OARs, while the spleen and heart ranged between 0.90 and 0.95. The stomach-bowel and pancreas exhibited DSC values below 0.90. Model-Combined demonstrated improved robustness across both datasets. Clinical evaluation revealed good usability, with both clinicians rating six of nine Type 1 OARs above four and six of eight Type 2 OARs above three. Significant performance differences were only found across age groups in both datasets, specifically in the left lung and pancreas. The 0-2 age group showed the lowest performance. A multi-organ segmentation model was developed, showcasing enhanced robustness when trained on combined datasets. This model is suitable for various OARs and can be applied to multiple datasets in clinical settings.