Abstract

Magnetic Resonance Imaging-based prostate segmentation is an essential task for adaptive radiotherapy and for radiomics studies whose purpose is to identify associations between imaging features and patient outcomes. Because manual delineation is a time-consuming task, we present three deep-learning (DL) approaches, namely UNet, efficient neural network (ENet), and efficient residual factorized convNet (ERFNet), whose aim is to tackle the fully-automated, real-time, and 3D delineation process of the prostate gland on T2-weighted MRI. While UNet is used in many biomedical image delineation applications, ENet and ERFNet are mainly applied in self-driving cars to compensate for limited hardware availability while still achieving accurate segmentation. We apply these models to a limited set of 85 manual prostate segmentations using the k-fold validation strategy and the Tversky loss function and we compare their results. We find that ENet and UNet are more accurate than ERFNet, with ENet much faster than UNet. Specifically, ENet obtains a dice similarity coefficient of 90.89% and a segmentation time of about 6 s using central processing unit (CPU) hardware to simulate real clinical conditions where graphics processing unit (GPU) is not always available. In conclusion, ENet could be efficiently applied for prostate delineation even in small image training datasets with potential benefit for patient management personalization.

Highlights

  • Introduction nal affiliationsIn the biomedical imaging field, target delineation is routinely used as the first step in any automatized disease diagnosis system and, in the last few years, in radiomics studies [1,2] to obtain a multitude of quantitative parameters from biomedical images [3,4]

  • Using a limited set of 85 manual prostate segmentation training data, we show that efficient neural network (ENet) model can be used to obtain accurate, fast and clinically acceptable prostate segmentations

  • We excluded patients from the study for (a) incomplete magnetic resonance imaging (MRI) examination due to intolerance, discomfort, or claustrophobia (n = 11); (b) patients with radical prostatectomy (n = 18), subjected to transurethral resection of the prostate (TURP) (n = 20), or radiotherapy (n = 17); (c) lack of median lobe enlargement defined as intra-vesical prostatic protrusion characterized by overgrowth of the prostatic median lobe into the bladder for at least 1 cm (n = 51)

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Summary

Introduction

In the biomedical imaging field, target delineation is routinely used as the first step in any automatized disease diagnosis system (i.e., radiotherapy system) and, in the last few years, in radiomics studies [1,2] to obtain a multitude of quantitative parameters from biomedical images [3,4]. Manual segmentation might seem like the simplest solution to obtain target boundaries, but it is a time-consuming and userdependent process that affects the radiomics signature [6] For this reason, an automatic and operator-independent target delineation method is mandatory.

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