QIAN Jiewei, ZHANG Huo, BAI Zhenglu, LI Jun, CHENG Pinjing, GENG Changran, LIU Ping
Objective To establish a multimodal image-based automatic segmentation model for the clinical target volume (CTV) and organs at risk (OAR) in cervical cancer radiotherapy, and to construct and validate this model based on deep learning neural networks using simulation CT images and corresponding magnetic resonance images of patients receiving cervical cancer radiotherapy. Methods A total of 150 cases of simulation CT images and corresponding T2-weighted magnetic resonance images from patients who underwent cervical cancer radiotherapy at Northern Jiangsu People’s Hospital from January 2022 to September 2023 were retrospectively collected and preprocessed. These cases were randomly divided into a training set of 100 cases, a validation set of 25 cases and a test set of 25 cases. The multimodal images were simultaneously input into an automatic segmentation model constructed based on a deep learning neural network for training and validation, and automatic segmentation was then performed on the test set. Taking the manual segmentation results of physicians as the “gold standard”, the accuracy of the automatic segmentation model for cervical cancer CTV and OAR (small intestine, bladder, rectum, left and right kidneys, left and right femoral heads) was calculated, and the time consumed for segmentation was recorded. Results The Dice similarity coefficient values of the automatic segmentation model for CTV and OAR (small intestine, bladder, rectum, left and right kidneys, left and right femoral heads) were 0.87±0.03, 0.79±0.04, 0.95±0.04, 0.88±0.04, 0.96±0.02, 0.96±0.03, 0.92±0.03 and 0.93±0.03, respectively. The 95% Hausdorff distance values were (5.12±1.45), (22.37±15.68), (1.27±0.31), (5.45±1.56), (1.15±0.21), (1.22±0.25), (4.51±2.38) and (4.56±2.77) mm, respectively. The Jaccard index values were 0.88±0.05, 0.83±0.04, 0.97±0.02, 0.91±0.04, 0.97±0.02, 0.97±0.03, 0.98±0.02 and 0.98±0.01, respectively. The time consumed for segmentation was (0.53±0.09), (0.36±0.06), (0.08±0.02), (0.09±0.03), (0.03±0.01), (0.03±0.01), (0.04±0.01) and (0.04±0.01) min, respectively, and the total time consumed to completely segment one case was (1.20±0.24) min. All differences were statistically significant (P<0.05). Conclusion The automatic segmentation model based on multimodal images established in this study can accurately segment the CTV and OAR for cervical cancer radiotherapy automatically, providing a certain reference for clinicians in target volume and organ segmentation and saving a substantial amount of clinical time.