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Morphometric Atlas Selection for Automatic Brachial Plexus Segmentation.

Joris Van de Velde1, Johan Wouters2, Tom Vercauteren3

  • 1Department of Anatomy, Ghent University, Ghent, Belgium; Department of Radiotherapy, Ghent University, Ghent, Belgium.

International Journal of Radiation Oncology, Biology, Physics
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Atlas selection impacts brachial plexus (BP) autosegmentation accuracy in radiation therapy planning. Greater differences in shoulder protraction-retraction between the patient and atlas significantly reduce segmentation accuracy.

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Area of Science:

  • Medical Imaging
  • Radiation Oncology
  • Anatomical Modeling

Background:

  • Accurate segmentation of the brachial plexus (BP) is crucial for radiation therapy planning to minimize off-target radiation exposure.
  • Automatic segmentation methods using computed tomography (CT) atlases offer efficiency but require validation regarding accuracy.
  • Atlas selection criteria, particularly anatomical variations, can influence the performance of these automated segmentation tools.

Purpose of the Study:

  • To evaluate how different morphometric parameters used for atlas selection affect the accuracy of automatic brachial plexus (BP) segmentation.
  • To determine the impact of atlas-patient anatomical differences on the reliability of BP autosegmentation for radiotherapy planning.

Main Methods:

  • Utilized 12 cadaver CT atlases, registering 11 onto one acting as a patient using deformable image registration.
  • Calculated Dice and Jaccard similarity indices and inclusion index to quantify BP segmentation accuracy against gold standards.
  • Measured and correlated morphometric parameters, including protraction-retraction distance, with segmentation accuracy metrics.

Main Results:

  • A significant negative correlation was found between the difference in shoulder protraction-retraction distance and BP segmentation similarity indices (mean Pearson r = -0.546).
  • Other investigated morphometric parameters showed weak correlations with segmentation accuracy.
  • This indicates that shoulder positioning differences are a key factor affecting autosegmentation performance.

Conclusions:

  • The shoulder protraction-retraction position during planning CT significantly influences the accuracy of automatic brachial plexus segmentation.
  • Increased discrepancy in protraction-retraction distance between the patient and the selected CT atlas leads to reduced accuracy in BP autosegmentation.
  • Optimizing atlas selection based on shoulder positioning parameters can improve the reliability of BP autosegmentation in radiation therapy planning.