Purpose: We aim to develop a fully automatic tool for accurate contouring of major male pelvic organs in CT images for radiotherapy without any manual initialization, yet still achieving superior performance than the existing tools. Methods: A learning-based 3D deformable shape model was developed for automatic contouring. Specifically, we utilized a recent machine learning method, random forest, to jointly learn both image regressor and classifier for each organ. In particular, the image regressor is trained to predict the 3D displacement from each vertex of the 3D shape model towards the organ boundary based on the local image appearance around the location of this vertex. The predicted 3D displacements are then used to drive the 3D shape model towards the target organ. Once the shape model is deformed close to the target organ, it is further refined by an organ likelihood map estimated by the learned classifier. As the organ likelihood map provides good guideline for the organ boundary, the precise contouring Result could be achieved, by deforming the 3D shape model locally to fit boundaries in the organ likelihood map. Results: We applied our method to 29 previously-treated prostate cancer patients, each with one planning CT scan. Compared with manually delineated pelvic organs, our method obtains overlap ratios of 85.2%±3.74% for the prostate, 94.9%±1.62% for the bladder, and 84.7%±1.97% for the rectum, respectively. Conclusion: This work demonstrated feasibility of a novel machine-learning based approach for accurate and automatic contouring of major male pelvic organs. It shows the potential to replace the time-consuming and inconsistent manual contouring in the clinic. Also, compared with the existing works, our method is more accurate and also efficient since it does not require any manual intervention, such as manual landmark placement. Moreover, our method obtained very similar contouring results as the clinical experts. Project is partially support by a grant from NCI 1R01CA140413
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