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dc.contributor.authorMason, SA
dc.contributor.authorO'Shea, TP
dc.contributor.authorWhite, IM
dc.contributor.authorLalondrelle, S
dc.contributor.authorDowney, K
dc.contributor.authorBaker, M
dc.contributor.authorBehrens, CF
dc.contributor.authorBamber, JC
dc.contributor.authorHarris, EJ
dc.date.accessioned2017-05-23T15:45:11Z
dc.date.issued2017-07
dc.identifier.citationMedical physics, 2017, 44 (7), pp. 3630 - 3638
dc.identifier.issn0094-2405
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/653
dc.identifier.eissn2473-4209
dc.identifier.doi10.1002/mp.12325
dc.description.abstractPurpose 3D ultrasound (US) images of the uterus may be used to adapt radiotherapy (RT) for cervical cancer patients based on changes in daily anatomy. This requires accurate on-line segmentation of the uterus. The aim of this work was to assess the accuracy of Elekta's "Assisted Gyne Segmentation" (AGS) algorithm in semi-automatically segmenting the uterus on 3D transabdominal ultrasound images by comparison with manual contours.Materials & methods Nine patients receiving RT for cervical cancer were imaged with the 3D Clarity ® transabdominal probe at RT planning, and 1 to 7 times during treatment. Image quality was rated from unusable (0)-excellent (3). Four experts segmented the uterus (defined as the uterine body and cervix) manually and using AGS on images with a ranking > 0. Pairwise analysis between manual contours was evaluated to determine interobserver variability. The accuracy of the AGS method was assessed by measuring its agreement with manual contours via pairwise analysis.Results 35/44 images acquired (79.5%) received a ranking > 0. For the manual contour variation, the median [interquartile range (IQR)] distance between centroids (DC) was 5.41 [5.0] mm, the Dice similarity coefficient (DSC) was 0.78 [0.11], the mean surface-to-surface distance (MSSD) was 3.20 [1.8] mm, and the uniform margin of 95% (UM95) was 4.04 [5.8] mm. There was no correlation between image quality and manual contour agreement. AGS failed to give a result in 19.3% of cases. For the remaining cases, the level of agreement between AGS contours and manual contours depended on image quality. There were no significant differences between the AGS segmentations and the manual segmentations on the images that received a quality rating of 3. However, the AGS algorithm had significantly worse agreement with manual contours on images with quality ratings of 1 and 2 compared with the corresponding interobserver manual variation. The overall median [IQR] DC, DSC, MSSD, and UM95 between AGS and manual contours was 5.48 [5.45] mm, 0.77 [0.14], 3.62 [2.7] mm, and 5.19 [8.1] mm, respectively.Conclusions The AGS tool was able to represent uterine shape of cervical cancer patients in agreement with manual contouring in cases where the image quality was excellent, but not in cases where image quality was degraded by common artifacts such as shadowing and signal attenuation. The AGS tool should be used with caution for adaptive RT purposes, as it is not reliable in accurately segmenting the uterus on 'good' or 'poor' quality images. The interobserver agreement between manual contours of the uterus drawn on 3D US was consistent with results of similar studies performed on CT and MRI images.
dc.formatPrint-Electronic
dc.format.extent3630 - 3638
dc.languageeng
dc.language.isoeng
dc.rights.urihttps://creativecommons.org/licenses/by/4.0
dc.subjectHumans
dc.subjectImaging, Three-Dimensional
dc.subjectUltrasonography
dc.subjectUltrasonography, Interventional
dc.subjectReproducibility of Results
dc.subjectAlgorithms
dc.subjectUterine Cervical Neoplasms
dc.subjectFemale
dc.titleTowards ultrasound-guided adaptive radiotherapy for cervical cancer: Evaluation of Elekta's semiautomated uterine segmentation method on 3D ultrasound images.
dc.typeJournal Article
dcterms.dateAccepted2017-03-29
rioxxterms.versionofrecord10.1002/mp.12325
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by/4.0
rioxxterms.licenseref.startdate2017-07
rioxxterms.typeJournal Article/Review
dc.relation.isPartOfMedical physics
pubs.issue7
pubs.notesNot known
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Closed research teams
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Closed research teams/Clinical Academic Radiotherapy (Dearnaley)
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Gynaecological Cancer
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Gynaecological Cancer/Gynaecological Cancer (hon.)
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Imaging for Radiotherapy Adaptation
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Ultrasound & Optical Imaging
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Closed research teams
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Closed research teams/Clinical Academic Radiotherapy (Dearnaley)
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Gynaecological Cancer
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Gynaecological Cancer/Gynaecological Cancer (hon.)
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Imaging for Radiotherapy Adaptation
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Ultrasound & Optical Imaging
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.publication-statusPublished
pubs.volume44
pubs.embargo.termsNot known
icr.researchteamClinical Academic Radiotherapy (Dearnaley)en_US
icr.researchteamGynaecological Canceren_US
icr.researchteamImaging for Radiotherapy Adaptationen_US
icr.researchteamUltrasound & Optical Imagingen_US
dc.contributor.icrauthorMason, Sarahen
dc.contributor.icrauthorHarris, Emmaen
dc.contributor.icrauthorBamber, Jeffreyen
dc.contributor.icrauthorLalondrelle, Susanen
dc.contributor.icrauthorWhite, Ingriden
dc.contributor.icrauthorMarsden,en


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