A Prior Knowledge-Guided, Deep Learning-Based Semiautomatic Segmentation for Complex Anatomy on Magnetic Resonance Imaging.

Abstract

Despite recent substantial improvement in autosegmentation using deep learning (DL) methods, labor-intensive and time-consuming slice-by-slice manual editing is often needed, particularly for complex anatomy (eg, abdominal organs). This work aimed to develop a fast, prior knowledge-guided DL semiautomatic segmentation (DL-SAS) method for complex structures on abdominal magnetic resonance imaging (MRI) scans. A novel application using contours on an adjacent slice as a prior knowledge informant in a 2-dimensional UNet DL model to guide autosegmentation for a subsequent slice was implemented for DL-SAS. A generalized, instead of organ-specific, DL-SAS model was trained and tested for abdominal organs on T2-weighted MRI scans collected from 75 patients (65 for training and 10 for testing). The DL-SAS model performance was compared with 3 common autocontouring methods (linear interpolation, rigid propagation, and a full 3-dimensional DL autosegmentation model trained with the same training data set) based on various quantitative metrics including the Dice similarity coefficient (DSC) and ratio of acceptable slices (ROA) using paired t tests. For the 10 testing cases, the DL-SAS model performed best with the slice interval (SI) of 1, resulting in an average DSC of 0.93 ± 0.02, 0.92 ± 0.02, 0.91 ± 0.02, 0.88 ± 0.03, and 0.87 ± 0.02 for the large bowel, stomach, small bowel, duodenum, and pancreas, respectively. The performance decreased with increased SIs from the guidance slice. The DL-SAS method performed significantly better (P < .05) than the other 3 methods. The ROA values were in the range of 48% to 66% for all the organs with an SI of 1 for DL-SAS, higher than those for linear interpolation (31%-57% for an SI of 1) and DL auto-segmentation (16%-51%). The developed DL-SAS model segmented complex abdominal structures on MRI with high accuracy and efficiency and may be implemented as an interactive manual contouring tool or a contour editing tool in conjunction with a full autosegmentation process, facilitating fast and accurate segmentation for MRI-guided online adaptive radiation therapy.