Deep Learning-based Segmentation Research Articles

Synthetic Optical Coherence Tomography Angiographs for Detailed Retinal Vessel Segmentation Without Human Annotations.

Optical coherence tomography angiography (OCTA) is a non-invasive imaging modality that can acquire high-resolution volumes of the retinal vasculature and aid the diagnosis of ocular, neurological and cardiac diseases. Segmenting the visible blood vessels is a common first step when extracting quantitative biomarkers from these images. Classical segmentation algorithms based on thresholding are strongly affected by image artifacts and limited signal-to-noise ratio. The use of modern, deep learning-based segmentation methods has been inhibited by a lack of large datasets with detailed annotations of the blood vessels. To address this issue, recent work has employed transfer learning, where a segmentation network is trained on synthetic OCTA images and is then applied to real data. However, the previously proposed simulations fail to faithfully model the retinal vasculature and do not provide effective domain adaptation. Because of this, current methods are unable to fully segment the retinal vasculature, in particular the smallest capillaries. In this work, we present a lightweight simulation of the retinal vascular network based on space colonization for faster and more realistic OCTA synthesis. We then introduce three contrast adaptation pipelines to decrease the domain gap between real and artificial images. We demonstrate the superior segmentation performance of our approach in extensive quantitative and qualitative experiments on three public datasets that compare our method to traditional computer vision algorithms and supervised training using human annotations. Finally, we make our entire pipeline publicly available, including the source code, pretrained models, and a large dataset of synthetic OCTA images.

Deep Learning-Based Segmentation and Risk Stratification for Gastrointestinal Stromal Tumors in Transabdominal Ultrasound Imaging.

To develop a deep neural network system for the automatic segmentation and risk stratification prediction of gastrointestinal stromal tumors (GISTs). A total of 980 ultrasound (US) images from 245 GIST patients were retrospectively collected. These images were randomly divided (6:2:2) into a training set, a validation set, and an internal test set. Additionally, 188 US images from 47 prospective GIST patients were collected to evaluate the segmentation and diagnostic performance of the model. Five deep learning-based segmentation networks, namely, UNet, FCN, DeepLabV3+, Swin Transformer, and SegNeXt, were employed, along with the ResNet 18 classification network, to select the most suitable network combination. The performance of the segmentation models was evaluated using metrics such as the intersection over union (IoU), Dice similarity coefficient (DSC), recall, and precision. The classification performance was assessed based on accuracy and the area under the receiver operating characteristic curve (AUROC). Among the compared models, SegNeXt-ResNet18 exhibited the best segmentation and classification performance. On the internal test set, the proposed model achieved IoU, DSC, precision, and recall values of 82.1, 90.2, 91.7, and 88.8%, respectively. The accuracy and AUC for GIST risk prediction were 87.4 and 92.0%, respectively. On the external test set, the segmentation models exhibited IoU, DSC, precision, and recall values of 81.0, 89.5, 92.8, and 86.4%, respectively. The accuracy and AUC for GIST risk prediction were 86.7 and 92.5%, respectively. This two-stage SegNeXt-ResNet18 model achieves automatic segmentation and risk stratification prediction for GISTs and demonstrates excellent segmentation and classification performance.

Kidney medicine meets computer vision: a bibliometric analysis.

Rapid advances in computer vision (CV) have the potential to facilitate the examination, diagnosis, and treatment of diseases of the kidney. The bibliometric study aims to explore the research landscape and evolving research focus of the application of CV in kidney medicine research. The Web of Science Core Collection was utilized to identify publications related to the research or applications of CV technology in the field of kidney medicine from January 1, 1900, to December 31, 2022. We analyzed emerging research trends, highly influential publications and journals, prolific researchers, countries/regions, research institutions, co-authorship networks, and co-occurrence networks. Bibliographic information was analyzed and visualized using Python, Matplotlib, Seaborn, HistCite, and Vosviewer. There was an increasing trend in the number of publications on CV-based kidney medicine research. These publications mainly focused on medical image processing, surgical procedures, medical image analysis/diagnosis, as well as the application and innovation of CV technology in medical imaging. The United States is currently the leading country in terms of the quantities of published articles and international collaborations, followed by China. Deep learning-based segmentation and machine learning-based texture analysis are the most commonly used techniques in this field. Regarding research hotspot trends, CV algorithms are shifting toward artificial intelligence, and research objects are expanding to encompass a wider range of kidney-related objects, with data dimensions used in research transitioning from 2D to 3D while simultaneously incorporating more diverse data modalities. The present study provides a scientometric overview of the current progress in the research and application of CV technology in kidney medicine research. Through the use of bibliometric analysis and network visualization, we elucidate emerging trends, key sources, leading institutions, and popular topics. Our findings and analysis are expected to provide valuable insights for future research on the use of CV in kidney medicine research.

Deep Learning-based Segmentation of Lesions from Wide-field Vitiligo Images

Deep Learning-based Segmentation of Lesions from Wide-field Vitiligo Images

DSBAV-Net: Depthwise Separable Bottleneck Attention V-Shaped Network with Hybrid Convolution for Left Atrium Segmentation

AbstractAccurate and precise segmentation of the left atrium (LA) is crucial in the early diagnosis and treatment of atrial fibrillation (AF), which is the most common heart rhythm disease in cases. The size of fibrotic tissue in patients with AF is based on manual examination of images obtained from the gadolinium-enhanced cardiac magnetic resonance imaging (MRI) technique. However, manual examination of the acquired images is time-consuming and has many difficulties, such as LA thickness between observers and resolution according to MR devices. To overcome the challenges of manual segmentation of images obtained from MRI devices, end-to-end, fully automated deep learning-based segmentation architectures have become extremely important today. In this study, an encoder–decoder-based V-shaped deep learning architecture is proposed for precise segmentation of LA. In the proposed architecture, standard convolution and depthwise separable convolution are used together. Thus, sparsely connected blocks with fewer parameters and deeply separable convolutions learn the feature representations better, increasing the robustness of the model. In addition, the bottleneck attention module has been added to each encoder layer, allowing the network to learn which features to focus on and which features to suppress in images by attention mapping channel and spatially. The proposed architecture obtained 0.915 dice and 0.844 Jaccard scores in the STACOM 2018 challenge dataset. The obtained results draw attention to the robustness of the model.

Optimizing deep learning-based segmentation of densely packed cells using cell surface markers

BackgroundSpatial molecular profiling depends on accurate cell segmentation. Identification and quantitation of individual cells in dense tissues, e.g. highly inflamed tissue caused by viral infection or immune reaction, remains a challenge.MethodsWe first assess the performance of 18 deep learning-based cell segmentation models, either pre-trained or trained by us using two public image sets, on a set of immunofluorescence images stained with immune cell surface markers in skin tissue obtained during human herpes simplex virus (HSV) infection. We then further train eight of these models using up to 10,000+ training instances from the current image set. Finally, we seek to improve performance by tuning parameters of the most successful method from the previous step.ResultsThe best model before fine-tuning achieves a mean Average Precision (mAP) of 0.516. Prediction performance improves substantially after training. The best model is the cyto model from Cellpose. After training, it achieves an mAP of 0.694; with further parameter tuning, the mAP reaches 0.711.ConclusionSelecting the best model among the existing approaches and further training the model with images of interest produce the most gain in prediction performance. The performance of the resulting model compares favorably to human performance. The imperfection of the final model performance can be attributed to the moderate signal-to-noise ratio in the imageset.

Comparative assessment of established and deep learning-based segmentation methods for hippocampal volume estimation in brain magnetic resonance imaging analysis.

In this study, our objective was to assess the performance of two deep learning-based hippocampal segmentation methods, SynthSeg and TigerBx, which are readily available to the public. We contrasted their performance with that of two established techniques, FreeSurfer-Aseg and FSL-FIRST, using three-dimensional T1-weighted MRI scans (n = 1447) procured from public databases. Our evaluation focused on the accuracy and reproducibility of these tools in estimating hippocampal volume. The findings suggest that both SynthSeg and TigerBx are on a par with Aseg and FIRST in terms of segmentation accuracy and reproducibility, but offer a significant advantage in processing speed, generating results in less than 1 min compared with several minutes to hours for the latter tools. In terms of Alzheimer's disease classification based on the hippocampal atrophy rate, SynthSeg and TigerBx exhibited superior performance. In conclusion, we evaluated the capabilities of two deep learning-based segmentation techniques. The results underscore their potential value in clinical and research environments, particularly when investigating neurological conditions associated with hippocampal structures.

Local and global changes in cell density induce reorganisation of 3D packing in a proliferating epithelium.

Tissue morphogenesis is intimately linked to the changes in shape and organisation of individual cells. In curved epithelia, cells can intercalate along their own apicobasal axes, adopting a shape named 'scutoid' that allows energy minimization in the tissue. Although several geometric and biophysical factors have been associated with this 3D reorganisation, the dynamic changes underlying scutoid formation in 3D epithelial packing remain poorly understood. Here, we use live imaging of the sea star embryo coupled with deep learning-based segmentation to dissect the relative contributions of cell density, tissue compaction and cell proliferation on epithelial architecture. We find that tissue compaction, which naturally occurs in the embryo, is necessary for the appearance of scutoids. Physical compression experiments identify cell density as the factor promoting scutoid formation at a global level. Finally, the comparison of the developing embryo with computational models indicates that the increase in the proportion of scutoids is directly associated with cell divisions. Our results suggest that apico-basal intercalations appearing immediately after mitosis may help accommodate the new cells within the tissue. We propose that proliferation in a compact epithelium induces 3D cell rearrangements during development.

Development and validation of a reliable method for automated measurements of psoas muscle volume in CT scans using deep learning-based segmentation: a cross-sectional study

ObjectivesWe aimed to develop an automated method for measuring the volume of the psoas muscle using CT to aid sarcopenia research efficiently.MethodsWe used a data set comprising the CT scans...

Conquering Class Imbalances in Deep Learning-based Segmentation of Dental Radiographs with Different Loss Functions.

ObjectiveThe imbalanced nature of real-world datasets is an ongoing challenge in the field of machine and deep learning. In medicine and in dentistry, most data samples represent patients not affected by pathologies, and on imagery, pathologic image areas are often smaller than healthy ones. Selecting suitable loss functions during deep learning is essential and may help to overcome the resulting imbalance. We assessed six different loss functions for one exemplary task, tooth structure segmentation on bitewing radiographs, for their performance. MethodsSix different loss functions (Focal Loss, Dice Loss, Tversky Loss and hybrid losses of Cross-Entropy and Dice Loss, Focal and Dice Loss, Focal and Generalized Dice Loss) were compared on a tooth structure segmentation task of 1,625 bitewing radiographs. Training was performed using three different model architectures (U-Net, Linknet, DeepLavbV3+) over a 5-fold cross-validation. Tooth structures consisted of the classes (occurrence in % of samples/captures areas measured on pixel level) enamel (100%/25%), dentin (100%/50%), root canal (100%/10%), filling (81%/8%) and crown (28%/5%). ResultsHybrid loss functions significantly outperformed standalone ones and provided robust results over the different architectures for the classes enamel, dentin, root canal and filling. Specifically, the Dice Focal loss reached high performance to conquer both image level and pixel level class imbalance, respectively. Clinical SignificanceIn dental use cases it is often important to predict minority classes such as pathologies accurately. Using specific loss function may be an effective strategy to overcome data imbalance when training deep learning models.

Feature Sparse Choosing VIT Model for Efficient Concrete Crack Segmentation in Portable Crack Measuring Devices

Concrete crack measurement is important for concrete buildings. Deep learning-based segmentation methods have achieved state-of-art results. However, the model size of these models is extremely large which is impossible to use in portable crack measuring devices. To address this problem, a light-weight concrete crack segmentation model based on the Feature Sparse Choosing VIT (LTNet) is proposed by us. In our proposed model, a Feature Sparse Choosing VIT (FSVIT) is used to reduce computational complexity in VIT as well as reducing the number of channels for crack features. In addition, a Feature Channel Selecting Module (FCSM) is proposed by us to reduce channel features as well as suppressing the influence of interfering features. Finally, Depthwise Separable Convolutions are used to substitute traditional convolutions for further reducing computational complexity. As a result, the model size of our LTNet is extremely small. Experimental results show that our LTNet could achieve an accuracy of 0.887, 0.817 and 0.693, and achieve a recall of 0.882, 0.805 and 0.681 on three datasets, respectively, which is 3–8% higher than current mainstream algorithms. However, the model size of our LTNet is only 2 M.

Distilling Knowledge from a Transformer-Based Crack Segmentation Model to a Light-Weighted Symmetry Model with Mixed Loss Function for Portable Crack Detection Equipment

The detection of cracks is extremely important for maintenance of concrete structures. Deep learning-based segmentation models have achieved high accuracy in crack segmentation. However, mainstream crack segmentation models have very high computational complexity, and therefore cannot be used in portable crack detection equipment. To address this problem, a knowledge distilling structure is designed by us. In this structure, a large teacher model named TBUNet is proposed to transfer crack knowledge to a student model with symmetry structure named ULNet. In the TBUNet, stacked transformer modules are used to capture dependency relationships between different crack positions in feature maps and achieve contextual awareness. In the ULNet, only a tiny U-Net with light-weighted parameters is used to maintain very low computational complexity. In addition, a mixed loss function is designed to ensure detail and global features extracted by the teacher model are consistent with those of the student model. Our designed experiments demonstrate that the ULNet can achieve accuracies of 96.2%, 87.6%, and 75.3%, and recall of 97.1%, 88.5%, and 76.2% on the Cracktree200, CRACK500, and MICrack datasets, respectively, which is 4–6% higher than most crack segmentation models. However, the ULNet only has a model size of 1 M, which is suitable for use in portable crack detection equipment.

Evaluating the relationship between magnetic resonance image quality metrics and deep learning-based segmentation accuracy of brain tumors.

Magnetic resonance imaging (MRI) scans are known to suffer from a variety of acquisition artifacts as well as equipment-based variations that impact image appearance and segmentation performance. It is still unclear whether a direct relationship exists between magnetic resonance (MR) image quality metrics (IQMs) (e.g., signal-to-noise, contrast-to-noise) and segmentation accuracy. Deep learning (DL) approaches have shown significant promise for automated segmentation of brain tumors on MRI but depend on the quality of input training images. We sought to evaluate the relationship between IQMs of input training images and DL-based brain tumor segmentation accuracy toward developing more generalizable models for multi-institutional data. We trained a 3D DenseNet model on the BraTS 2020 cohorts for segmentation of tumor subregions enhancing tumor (ET), peritumoral edematous, and necrotic and non-ET on MRI; with performance quantified via a 5-fold cross-validated Dice coefficient. MRI scans were evaluated through the open-source quality control tool MRQy, to yield 13 IQMs per scan. The Pearson correlation coefficient was computed between whole tumor (WT) dice values and IQM measures in the training cohorts to identify quality measures most correlated with segmentation performance. Each selected IQM was used to group MRI scans as "better" quality (BQ) or "worse" quality (WQ), via relative thresholding. Segmentation performance was re-evaluated for the DenseNet model when (i) training on BQ MRI images with validation on WQ images, as well as (ii) training on WQ images, and validation on BQ images. Trends were further validated on independent test sets derived from the BraTS 2021 training cohorts. For this study, multimodal MRI scans from the BraTS 2020 training cohorts were used to train the segmentation model and validated on independent test sets derived from the BraTS 2021 cohort. Among the selected IQMs, models trained on BQ images based on inhomogeneity measurements (coefficient of variance, coefficient of joint variation, coefficient of variation of the foreground patch) and the models trained on WQ images based on noise measurement peak signal-to-noise ratio (SNR) yielded significantly improved tumor segmentation accuracy compared to their inverse models. Our results suggest that a significant correlation may exist between specific MR IQMs and DenseNet-based brain tumor segmentation performance. The selection of MRI scans for model training based on IQMs may yield more accurate and generalizable models in unseen validation.

Tools and methods for high-throughput single-cell imaging with the mother machine

Despite much progress, image processing remains a significant bottleneck for high-throughput analysis of microscopy data. One popular platform for single-cell time-lapse imaging is the mother machine, which enables long-term tracking of microbial cells under precisely controlled growth conditions. While several mother machine image analysis pipelines have been developed in the past several years, adoption by a non-expert audience remains a challenge. To fill this gap, we implemented our own software, MM3, as a plugin for the multidimensional image viewer napari. napari-MM3 is a complete and modular image analysis pipeline for mother machine data, which takes advantage of the high-level interactivity of napari. Here, we give an overview of napari-MM3 and test it against several well-designed and widely used image analysis pipelines, including BACMMAN and DeLTA. Researchers often analyze mother machine data with custom scripts using varied image analysis methods, but a quantitative comparison of the output of different pipelines has been lacking. To this end, we show that key single-cell physiological parameter correlations and distributions are robust to the choice of analysis method. However, we also find that small changes in thresholding parameters can systematically alter parameters extracted from single-cell imaging experiments. Moreover, we explicitly show that in deep learning-based segmentation, ‘what you put is what you get’ (WYPIWYG) – that is, pixel-level variation in training data for cell segmentation can propagate to the model output and bias spatial and temporal measurements. Finally, while the primary purpose of this work is to introduce the image analysis software that we have developed over the last decade in our lab, we also provide information for those who want to implement mother machine-based high-throughput imaging and analysis methods in their research.

Tools and methods for high-throughput single-cell imaging with the mother machine.

Despite much progress, image processing remains a significant bottleneck for high-throughput analysis of microscopy data. One popular platform for single-cell time-lapse imaging is the mother machine, which enables long-term tracking of microbial cells under precisely controlled growth conditions. While several mother machine image analysis pipelines have been developed in the past several years, adoption by a non-expert audience remains a challenge. To fill this gap, we implemented our own software, MM3, as a plugin for the multidimensional image viewer napari. napari-MM3 is a complete and modular image analysis pipeline for mother machine data, which takes advantage of the high-level interactivity of napari. Here, we give an overview of napari-MM3 and test it against several well-designed and widely used image analysis pipelines, including BACMMAN and DeLTA. Researchers often analyze mother machine data with custom scripts using varied image analysis methods, but a quantitative comparison of the output of different pipelines has been lacking. To this end, we show that key single-cell physiological parameter correlations and distributions are robust to the choice of analysis method. However, we also find that small changes in thresholding parameters can systematically alter parameters extracted from single-cell imaging experiments. Moreover, we explicitly show that in deep learning-based segmentation, 'what you put is what you get' (WYPIWYG) - that is, pixel-level variation in training data for cell segmentation can propagate to the model output and bias spatial and temporal measurements. Finally, while the primary purpose of this work is to introduce the image analysis software that we have developed over the last decade in our lab, we also provide information for those who want to implement mother machine-based high-throughput imaging and analysis methods in their research.

EH-former: Regional easy-hard-aware transformer for breast lesion segmentation in ultrasound images

Breast lesion segmentation of ultrasound images plays a crucial role in early screening and diagnosis of breast lesions. However, accurately segmenting lesions in breast ultrasound (BUS) images is challenging due to prevalent issues such as low contrast, intense speckle noise, and blurred lesion boundaries. Although existing deep learning-based segmentation models have made significant progress, few have strategically addressed these complex and noisy regional features in BUS images. The easy-to-hard manner in Curriculum Learning (CL) appears promising, but it often remains at the sample level and does not adequately address regional complexities. To address this, we design a region-wise CL to dynamically adjust the focus on hard regional features in BUS images. Specifically, we propose a Regional Easy-Hard-Aware Transformer (EH-Former), structured in two stages for lesion segmentation in BUS images. The first stage incorporates uncertainty estimation for dividing regional difficulty. In the second stage, we propose a novel Adaptive Easy-Hard region Separator (AdaSep), a module employing uncertainty-aware regularization to separate features of varying difficulties, allowing the two streams within EH-Former to focus on learning regional features of different complexities. Additionally, we develop a Dynamic Easy-Hard Feature Fusion (D-Fusion) module, dynamically adjusting the fusion weight of easy and hard regional features based on the current training epoch to achieve progressive regional feature learning. Extensive experimental results on five public datasets show that the proposed EH-Former consistently outperforms state-of-the-art methods in most metrics and exhibits better domain generalization capabilities. Furthermore, our region-wise CL significantly enhances the performance of EH-Former in detecting complex tissue structures and noisy areas that are challenging to segment accurately. The source code is available at https://github.com/lele0109/EH-Former.

Cascaded cross-attention transformers and convolutional neural networks for multi-organ segmentation in male pelvic computed tomography.

Segmentation of the prostate and surrounding organs at risk from computed tomography is required for radiation therapy treatment planning. We propose an automatic two-step deep learning-based segmentation pipeline that consists of an initial multi-organ segmentation network for organ localization followed by organ-specific fine segmentation. Initial segmentation of all target organs is performed using a hybrid convolutional-transformer model, axial cross-attention UNet. The output from this model allows for region of interest computation and is used to crop tightly around individual organs for organ-specific fine segmentation. Information from this network is also propagated to the fine segmentation stage through an image enhancement module, highlighting regions of interest in the original image that might be difficult to segment. Organ-specific fine segmentation is performed on these cropped and enhanced images to produce the final output segmentation. We apply the proposed approach to segment the prostate, bladder, rectum, seminal vesicles, and femoral heads from male pelvic computed tomography (CT). When tested on a held-out test set of 30 images, our two-step pipeline outperformed other deep learning-based multi-organ segmentation algorithms, achieving average dice similarity coefficient (DSC) of (prostate), (bladder), (rectum), (seminal vesicles), and (femoral heads). Our results demonstrate that a two-step segmentation pipeline with initial multi-organ segmentation and additional fine segmentation can delineate male pelvic CT organs well. The utility of this additional layer of fine segmentation is most noticeable in challenging cases, as our two-step pipeline produces noticeably more accurate and less erroneous results compared to other state-of-the-art methods on such images.

Retinal vasculature of different diameters and plexuses exhibit distinct vulnerability in varying severity of diabetic retinopathy.

To study the changes in vessel densities (VD) stratified by vessel diameter in the retinal superficial and deep vascular complexes (SVC/DVC) using optical coherence tomography angiography (OCTA) images obtained from people with diabetes and age-matched healthy controls. We quantified the VD based on vessel diameter categorized as <10, 10-20 and >20 μm in the SVC/DVC obtained on 3 × 3 mm2 OCTA scans using a deep learning-based segmentation and vascular graph extraction tool in people with diabetes and age-matched healthy controls. OCTA images obtained from 854 eyes of 854 subjects were divided into 5 groups: healthy controls (n = 555); people with diabetes with no diabetic retinopathy (DR, n = 90), mild and moderate non-proliferative DR (NPDR) (n = 96), severe NPDR (n = 42) and proliferative DR (PDR) (n = 71). Both SVC and DVC showed significant decrease in VD with increasing DR severity (p < 0.001). The largest difference was observed in the <10 μm vessels of the SVC between healthy controls and no DR (13.9% lower in no DR, p < 0.001). Progressive decrease in <10 μm vessels of the SVC and DVC was seen with increasing DR severity (p < 0.001). However, 10-20 μm vessels only showed decline in the DVC, but not the SVC (p < 0.001) and there was no change observed in the >20 μm vessels in either plexus. Our findings suggest that OCTA is able to demonstrate a distinct vulnerability of the smallest retinal vessels in both plexuses that worsens with increasing severity of DR.

Adversarial Attacks on Medical Segmentation Model via Transformation of Feature Statistics

Deep learning-based segmentation models have made a profound impact on medical procedures, with U-Net based computed tomography (CT) segmentation models exhibiting remarkable performance. Yet, even with these advances, these models are found to be vulnerable to adversarial attacks, a problem that equally affects automatic CT segmentation models. Conventional adversarial attacks typically rely on adding noise or perturbations, leading to a compromise between the success rate of the attack and its perceptibility. In this study, we challenge this paradigm and introduce a novel generation of adversarial attacks aimed at deceiving both the target segmentation model and medical practitioners. Our approach aims to deceive a target model by altering the texture statistics of an organ while retaining its shape. We employ a real-time style transfer method, known as the texture reformer, which uses adaptive instance normalization (AdaIN) to change the statistics of an image’s feature.To induce transformation, we modify the AdaIN, which typically aligns the source and target image statistics. Through rigorous experiments, we demonstrate the effectiveness of our approach. Our adversarial samples successfully pass as realistic in blind tests conducted with physicians, surpassing the effectiveness of contemporary techniques. This innovative methodology not only offers a robust tool for benchmarking and validating automated CT segmentation systems but also serves as a potent mechanism for data augmentation, thereby enhancing model generalization. This dual capability significantly bolsters advancements in the field of deep learning-based medical and healthcare segmentation models.

Assessment of lymph node area coverage with total marrow irradiation and implementation of total marrow and lymphoid irradiation using automated deep learning-based segmentation.

Total marrow irradiation (TMI) and total marrow and lymphoid irradiation (TMLI) have the advantages. However, delineating target lesions according to TMI and TMLI plans is labor-intensive and time-consuming. In addition, although the delineation of target lesions between TMI and TMLI differs, the clinical distinction is not clear, and the lymph node (LN) area coverage during TMI remains uncertain. Accordingly, this study calculates the LN area coverage according to the TMI plan. Further, a deep learning-based model for delineating LN areas is trained and evaluated. Whole-body regional LN areas were manually contoured in patients treated according to a TMI plan. The dose coverage of the delineated LN areas in the TMI plan was estimated. To train the deep learning model for automatic segmentation, additional whole-body computed tomography data were obtained from other patients. The patients and data were divided into training/validation and test groups and models were developed using the "nnU-NET" framework. The trained models were evaluated using Dice similarity coefficient (DSC), precision, recall, and Hausdorff distance 95 (HD95). The time required to contour and trim predicted results manually using the deep learning model was measured and compared. The dose coverage for LN areas by TMI plan had V100% (the percentage of volume receiving 100% of the prescribed dose), V95%, and V90% median values of 46.0%, 62.1%, and 73.5%, respectively. The lowest V100% values were identified in the inguinal (14.7%), external iliac (21.8%), and para-aortic (42.8%) LNs. The median values of DSC, precision, recall, and HD95 of the trained model were 0.79, 0.83, 0.76, and 2.63, respectively. The time for manual contouring and simply modified predicted contouring were statistically significantly different. The dose coverage in the inguinal, external iliac, and para-aortic LN areas was suboptimal when treatment is administered according to the TMI plan. This research demonstrates that the automatic delineation of LN areas using deep learning can facilitate the implementation of TMLI.