Abstract

BackgroundAccurate segmentation of lung lobe on routine computed tomography (CT) images of locally advanced stage lung cancer patients undergoing radiotherapy can help radiation oncologists to implement lobar-level treatment planning, dose assessment and efficacy prediction. We aim to establish a novel 2D–3D hybrid convolutional neural network (CNN) to provide reliable lung lobe auto-segmentation results in the clinical setting.MethodsWe retrospectively collected and evaluated thorax CT scans of 105 locally advanced non-small-cell lung cancer (NSCLC) patients treated at our institution from June 2019 to August 2020. The CT images were acquired with 5 mm slice thickness. Two CNNs were used for lung lobe segmentation, a 3D CNN for extracting 3D contextual information and a 2D CNN for extracting texture information. Contouring quality was evaluated using six quantitative metrics and visual evaluation was performed to assess the clinical acceptability.ResultsFor the 35 cases in the test group, Dice Similarity Coefficient (DSC) of all lung lobes contours exceeded 0.75, which met the pass criteria of the segmentation result. Our model achieved high performances with DSC as high as 0.9579, 0.9479, 0.9507, 0.9484, and 0.9003 for left upper lobe (LUL), left lower lobe (LLL), right upper lobe (RUL), right lower lobe (RLL), and right middle lobe (RML), respectively. The proposed model resulted in accuracy, sensitivity, and specificity of 99.57, 98.23, 99.65 for LUL; 99.6, 96.14, 99.76 for LLL; 99.67, 96.13, 99.81 for RUL; 99.72, 92.38, 99.83 for RML; 99.58, 96.03, 99.78 for RLL, respectively. Clinician's visual assessment showed that 164/175 lobe contours met the requirements for clinical use, only 11 contours need manual correction.ConclusionsOur 2D–3D hybrid CNN model achieved accurate automatic segmentation of lung lobes on conventional slice-thickness CT of locally advanced lung cancer patients, and has good clinical practicability.

Highlights

  • Accurate segmentation of lung lobe on routine computed tomography (CT) images of locally advanced stage lung cancer patients undergoing radiotherapy can help radiation oncologists to implement lobar-level treatment planning, dose assessment and efficacy prediction

  • We propose a 2D–3D hybrid segmentation network based on a convolutional neural network to automatically segment lung lobes from 5 mm slice-thickness computed tomography (CT) images

  • All the automatic segmentation profiles were divided into five groups according to the left upper lobe, left lower lobe, right upper lobe, right middle lobe, and right lower lobe

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Summary

Introduction

Accurate segmentation of lung lobe on routine computed tomography (CT) images of locally advanced stage lung cancer patients undergoing radiotherapy can help radiation oncologists to implement lobar-level treatment planning, dose assessment and efficacy prediction. Radiotherapy is considered the main option for locally advanced lung cancer patients. Radiotherapy improves locoregional control and survival in patients with lung cancer, radiation-induced lung injury (RILI) is common treatmentrelated toxicity, which can be fatal in severe cases. Some recent studies [7,8,9] suggest that lobar level treatment planning and radiation dose assessment may be an accessible way to improve treatment planning and reduce the incidence of radiation-induced lung injury. There is the prerequisite to develop a fully automatic methodology that produces reliable segmentation of the lung lobe in the clinical setting

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