Automated Segmentation And Clinical Target Volumes Definition For Nasopharyngeal Cancer Radiation Treatment Using Computed Tomography, Non New Net And Landmarks

dc.contributor.advisorPinsky, Lawrence S.
dc.contributor.committeeMemberCourt, Laurence E.
dc.contributor.committeeMemberNetherton, Tucker J.
dc.contributor.committeeMemberCardenas, Carlos E.
dc.contributor.committeeMemberMiller, John H., Jr.
dc.contributor.committeeMemberMeier, Mark A.
dc.creatorSjogreen, Carlos Andres
dc.creator.orcid0000-0002-6584-7670 2023
dc.description.abstractPurpose: Delineation of Clinical Target Volumes (CTVs) for nasopharyngeal cancer radiotherapy is inherently complex, primarily due to the variability in disease location and extent. This study introduces an auto-contouring tool developed following the NRG-HN001 protocol, demonstrating significant reconfigurability to align with the RTOG-0225 protocol. Methods: The study employed no-new-net (nnU-Net) architecture to auto-contour 27 crucial normal structures in the head and neck region, a vital step for defining CTVs according to the NRG HN001 protocol. We defined high-risk (CTV1, CTV2) and low- risk (CTV3, CTV4) CTVs using adjustable morphological geometric landmarks, thereby emulating physicians’ interpretation of protocol rules. This flexibility enabled our tool to switch between the NRG-HN001 and RTOG-0225 protocols swiftly. The results underwent evaluation using the Dice-Similarity-Coefficient (DSC) and Mean-Surface-Distance (MSD) metrics, alongside independent reviews by two physicians. Results: Comparisons between auto-contours and clinical contours for the NRG- HN001 protocol, carried out across 19 cancer patients of varying stages, revealed a DSC of 0.94±0.02, MSD of 0.4±0.4mm for high-risk CTVs, and DSC of 0.83±0.02, MSD of 2.4±0.5mm for low-risk CTVs. For the RTOG-0225 protocol, a physician reviewed 42 Na- sopharynx cases, identifying ten major deviations from the protocol. Comparisons between automatic contours and these 42 cases indicated statistically significant p-values (p=0.016) in DSC metrics, signifying the tool’s effectiveness in detecting major protocol deviations. Notably, the tool swiftly transitioned between the NRG-HN001 and RTOG-0225 protocols. We also noted statistical significance for the mean dose in the parotids and Larynx and for D1% with a p-value of 0.00 for brainstem, optic chiasm, and eyes. Conclusions: The study underscores the auto-contouring tool’s capability to delineate nasopharyngeal CTVs reliably following the NRG-HN001 protocol, and its configurability to meet the RTOG-0225 protocol requirements. The tool displayed high accuracy for nasopharyngeal CTVs and was clinically acceptable by two physicians in at least 90% of the cases. The tool’s capacity to detect significant protocol deviations and its po- tential to enhance radiation therapy process precision are noteworthy. The calculated Area Under the Curve (AUC) was found to be 0.75, indicating its good-to-moderate discriminative ability, further underscoring its clinical relevance.
dc.description.departmentPhysics, Department of
dc.format.digitalOriginborn digital
dc.rightsThe author of this work is the copyright owner. UH Libraries and the Texas Digital Library have their permission to store and provide access to this work. Further transmission, reproduction, or presentation of this work is prohibited except with permission of the author(s).
dc.subjectnnU-net, U-net, Landmarks, Nasopharyngeal Cancer.
dc.titleAutomated Segmentation And Clinical Target Volumes Definition For Nasopharyngeal Cancer Radiation Treatment Using Computed Tomography, Non New Net And Landmarks
dcterms.accessRightsThe full text of this item is not available at this time because the student has placed this item under an embargo for a period of time. The Libraries are not authorized to provide a copy of this work during the embargo period.
local.embargo.terms2025-08-01 of Natural Sciences and Mathematics, Department of of Houston of Philosophy


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