Mo Shaoling,Liu Yimei,Yang Xin,He Liru,Huang Sijuan.Robustness of MRI-based manual segmentation of organs at risk for cervical cancer[J].Chinese Journal of Radiological Medicine and Protection,2020,40(9):674-678
Robustness of MRI-based manual segmentation of organs at risk for cervical cancer
Received:January 10, 2020  
DOI:10.3760/cma.j.issn.0254-5098.2020.09.004
KeyWords:Manually segmentation  Cervical cancer  Magnetic resonance image  Organs-at-risk
FundProject:广东省自然科学基金(2017A030310217)
Author NameAffiliationE-mail
Mo Shaoling Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou 510060  
Liu Yimei Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou 510060  
Yang Xin Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou 510060  
He Liru Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou 510060  
Huang Sijuan Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou 510060 黄思娟,huangsj@sysucc.org.cn 
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Abstract::
      Objective The aim of the study is to investigate the inter-observer and intra-observer precision in manually segmentation of organs-at-risk(OARs) for cervical cancer on the basis of MR image, and to preliminarily explore sequence selection designed for radiotherapy planning. Methods Thirty cervical cancer patients scanned by MR-sim from 2016 to 2018 in the department of radiotherapy of Sun Yat-sen university cancer center were retrospectively analyzed. T1WI, T1dixonc and T2WI sequence from MR-simulator were selected and imported into Monaco planning system. Manual segmentation of 5 organs-at-risk (bladder, rectum, anal canal, and left/right femoral head) was done by 2 independent experienced physicians on three sequences acquired from these patients. A month later, the second segmentation of the OARs in the T1WI sequence was done by one of the two physicians. Dice similarity coefficient (DSC), Hausdorff distance (HD) and position difference(Δx, Δy, Δz) of each OAR were used to analyze the robustness of inter-observer and intra-observer segmentation OARs. Results The HD values of five OARs segmentation by the two physicians in T1WI, T1dixonc and T2WI sequences and the same physician in T1WI at different time were all less than 2 mm; the position differences were less than 5 mm. The DSC values, HD values and difference position values of the two physician and the same physician at different time was positively correlated with the volume of OARs (R=0.178-0.582, P<0.05). Due to the small volume of the anal canal (7.385±1.555) cm3, the DSC values were less than 0.7 and the performance was slightly worse. The average DSC values of other OARs were all greater than 0.82. Comparing the DSC, HD and position differences of OARs in the three sequences, DSC values of rectum, left/right femoral head and bladder, HD values of left/right femoral head and rectum, and Δz axis difference of anal canal and right femoral head of T1WI sequence were better than T1dixonc (t=-3.116-3.604, P<0.05); DSC value of rectum and HD value of anal canal in T1WI sequence were better than T2WI sequence(t=2.934, 3.677,P<0.05);T1dixonc sequence rectal DSC, right femoral head Δz axis difference were slightly better than T2WI(t=6.806,2.130,P<0.05). T2WI sequence bone tissue (left/right femoral head) stability was better than T1WI, T1dixonc, and the difference was statistically significant (t=-6.580-6.542,P<0.05). Conclusions From three index of DSC, HD and position difference, the robustness of inter-observer and intra-observer segmentation of bladder, rectum and femoral head are fine based on MR sequence, followed by anal canal. In addition, the robustness of OARs segmentation by T1WI sequence is better than that of T1dixonc and T2WI sequence.
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