Machine learning-based detection of aberrant deep learning segmentations of target and organs at risk for prostate radiotherapy using a secondary segmentation algorithm.

Journal: Physics in medicine and biology
Published Date:

Abstract

The output of a deep learning (DL) auto-segmentation application should be reviewed, corrected if needed and approved before being used clinically. This verification procedure is labour-intensive, time-consuming and user-dependent, which potentially leads to significant errors with impact on the overall treatment quality. Additionally, when the time needed to correct auto-segmentations approaches the time to delineate target and organs at risk from scratch, the usability of the DL model can be questioned. Therefore, an automated quality assurance framework was developed with the aim to detect in advance aberrant auto-segmentations.. Five organs (prostate, bladder, anorectum, femoral head left and right) were auto-delineated on CT acquisitions for 48 prostate patients by an in-house trained primary DL model. An experienced radiation oncologist assessed the correctness of the model output and categorised the auto-segmentations into two classes whether minor or major adaptations were needed. Subsequently, an independent, secondary DL model was implemented to delineate the same structures as the primary model. Quantitative comparison metrics were calculated using both models' segmentations and used as input features for a machine learning classification model to predict the output quality of the primary model.. For every organ, the approach of independent validation by the secondary model was able to detect primary auto-segmentations that needed major adaptation with high sensitivity (recall = 1) based on the calculated quantitative metrics. The surface DSC and APL were found to be the most indicated parameters in comparison to standard quantitative metrics for the time needed to adapt auto-segmentations.. This proposed method includes a proof of concept for the use of an independent DL segmentation model in combination with a ML classifier to improve time saving during QA of auto-segmentations. The integration of such system into current automatic segmentation pipelines can increase the efficiency of the radiotherapy contouring workflow.

Authors

  • Michaël Claessens
    Faculty of Medicine and Health Sciences, University of Antwerp, Belgium; Department of Radiation Oncology, Iridium Cancer Network, Wilrijk (Antwerp), Belgium. Electronic address: michael.claessens@uantwerpen.be.
  • Verdi Vanreusel
    Department of Radiation Oncology, Iridium Network, Wilrijk (Antwerp), Belgium.
  • Geert De Kerf
    Department of Radiation Oncology, Iridium Network, Wilrijk (Antwerp), Belgium.
  • Isabelle Mollaert
    Department of Radiation Oncology, Iridium Network, Wilrijk (Antwerp), Belgium.
  • Fredrik Löfman
    RaySearch Laboratories, Stockholm, Sweden.
  • Mark J Gooding
    2 Mirada Medical Ltd, Oxford, UK.
  • Charlotte Brouwer
    University of Groningen, University Medical Center Groningen, Department of Radiation Oncology, The Netherlands. Electronic address: c.l.brouwer@umcg.nl.
  • Piet Dirix
    Department of Radiation Oncology, Iridium Network, Wilrijk (Antwerp), Belgium.
  • Dirk Verellen
    Department of Radiotherapy, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Belgium.