Validation of different automated segmentation models for target volume contouring in postoperative radiotherapy for breast cancer and regional nodal irradiation

Introduction - Target volume delineation is routinely performed in postoperative radiotherapy (RT) for breast cancer patients, but it is a time-consuming process. The aim of the present study was to validate the quality, clinical usability and institutional-specific implementation of different auto-...

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Main Authors: Meixner, Eva (Author) , Glogauer, Benjamin (Author) , Klüter, Sebastian (Author) , Wagner, Friedrich (Author) , Neugebauer, David (Author) , Hoeltgen, Line (Author) , Dinges, Lisa A. (Author) , Harrabi, Semi B. (Author) , Liermann, Jakob (Author) , Vinsensia, Maria (Author) , Weykamp, Fabian (Author) , Hoegen-Saßmannshausen, Philipp (Author) , Debus, Jürgen (Author) , Hörner-Rieber, Juliane (Author)
Format: Article (Journal)
Language:English
Published: 11 September 2024
In: Clinical and translational radiation oncology
Year: 2024, Volume: 49, Pages: 100855-1-100855-7
ISSN:2405-6308
DOI:10.1016/j.ctro.2024.100855
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1016/j.ctro.2024.100855
Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S2405630824001320
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Author Notes:Eva Meixner, Benjamin Glogauer, Sebastian Klüter, Friedrich Wagner, David Neugebauer, Line Hoeltgen, Lisa A. Dinges, Semi Harrabi, Jakob Liermann, Maria Vinsensia, Fabian Weykamp, Philipp Hoegen-Saßmannshausen, Jürgen Debus, Juliane Hörner-Rieber

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520 |a Introduction - Target volume delineation is routinely performed in postoperative radiotherapy (RT) for breast cancer patients, but it is a time-consuming process. The aim of the present study was to validate the quality, clinical usability and institutional-specific implementation of different auto-segmentation tools into clinical routine. - Methods - Three different commercially available, artificial intelligence-, ESTRO-guideline-based segmentation models (M1-3) were applied to fifty consecutive reference patients who received postoperative local RT including regional nodal irradiation for breast cancer for the delineation of clinical target volumes: the residual breast, implant or chestwall, axilla levels 1 and 2, the infra- and supraclavicular regions, the interpectoral and internal mammary nodes. Objective evaluation metrics of the created structures were conducted with the Dice similarity index (DICE) and the Hausdorff distance, and a manual evaluation of usability. - Results - The resulting geometries of the segmentation models were compared to the reference volumes for each patient and required no or only minor corrections in 72 % (M1), 64 % (M2) and 78 % (M3) of the cases. The median DICE and Hausdorff values for the resulting planning target volumes were 0.87-0.88 and 2.96-3.55, respectively. Clinical usability was significantly correlated with the DICE index, with calculated cut-off values used to define no or minor adjustments of 0.82-0.86. Right or left sided target and breathing method (deep inspiration breath hold vs. free breathing) did not impact the quality of the resulting structures. - Conclusion - Artificial intelligence-based auto-segmentation programs showed high-quality accuracy and provided standardization and efficient support for guideline-based target volume contouring as a precondition for fully automated workflows in radiotherapy treatment planning. 
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650 4 |a Quality assurance 
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