Simultaneous nonrigid registration, segmentation, and tumor detection in MRI guided cervical cancer radiation therapy

External beam radiation therapy (EBRT) for the treatment of cancer enables accurate placement of radiation dose on the cancerous region. However, the deformation of soft tissue during the course of treatment, such as in cervical cancer, presents significant challenges for the delineation of the target volume and other structures of interest. Furthermore, the presence and regression of pathologies such as tumors may violate registration constraints and cause registration errors. In this paper, automatic segmentation, nonrigid registration and tumor detection in cervical magnetic resonance (MR) data are addressed simultaneously using a unified Bayesian framework. The proposed novel method can generate a tumor probability map while progressively identifying the boundary of an organ of interest based on the achieved nonrigid transformation. The method is able to handle the challenges of significant tumor regression and its effect on surrounding tissues. The new method was compared to various currently existing algorithms on a set of 36 MR data from six patients, each patient has six T2-weighted MR cervical images. The results show that the proposed approach achieves an accuracy comparable to manual segmentation and it significantly outperforms the existing registration algorithms. In addition, the tumor detection result generated by the proposed method has a high agreement with manual delineation by a qualified clinician.