Validation of automatic segmentation of ribs for NTCP modeling

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• 作者：Barbara Stam ; Heike Peulen ; Maddalena M.G. Rossi ; José ; S.A. Belderbos ; Jan-Jakob Sonke ; ^{j.sonke@nki.nl" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Auto segmentation ; SBRT ; Rib fracture ; NTCP ; Lung cancer
• 刊名：Radiotherapy and Oncology
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：118
• 期：3
• 页码：528-534
• 全文大小：941 K

文摘

Determination of a dose–effect relation for rib fractures in a large patient group has been limited by the time consuming manual delineation of ribs. Automatic segmentation could facilitate such an analysis. We determine the accuracy of automatic rib segmentation in the context of normal tissue complication probability modeling (NTCP).

Materials and methods

Forty-one patients with stage I/II non-small cell lung cancer treated with SBRT to 54 Gy in 3 fractions were selected. Using the 4DCT derived mid-ventilation planning CT, all ribs were manually contoured and automatically segmented. Accuracy of segmentation was assessed using volumetric, shape and dosimetric measures. Manual and automatic dosimetric parameters D_x and EUD were tested for equivalence using the Two One-Sided T-test (TOST), and assessed for agreement using Bland–Altman analysis. NTCP models based on manual and automatic segmentation were compared.

Results

Automatic segmentation was comparable with the manual delineation in radial direction, but larger near the costal cartilage and vertebrae. Manual and automatic D_x and EUD were significantly equivalent. The Bland–Altman analysis showed good agreement. The two NTCP models were very similar.

Conclusions

Automatic rib segmentation was significantly equivalent to manual delineation and can be used for NTCP modeling in a large patient group.