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Automated applicator digitization for high-dose-rate cervix brachytherapy using image thresholding and density-based

Christopher L Deufel1, Shulan Tian2, Benjamin B Yan1

  • 1Department of Radiation Oncology, Mayo Clinic, Rochester, MN.

Brachytherapy
|October 10, 2019
PubMed
Summary

An automated algorithm for digitizing cervix brachytherapy applicators was developed. This method significantly reduces treatment planning time and human error, improving consistency in cancer treatment planning.

Keywords:
AutomationBrachytherapyCervixClusteringDigitizationHDRSegmentationTandem and ovoidsThreshold

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Area of Science:

  • Medical Physics
  • Oncology
  • Radiotherapy

Background:

  • High-dose-rate (HDR) brachytherapy is a crucial cancer treatment.
  • Cervix brachytherapy planning requires accurate digitization of applicators.
  • Manual digitization is time-consuming and prone to errors.

Purpose of the Study:

  • To develop and evaluate an automated digitization algorithm for HDR cervix brachytherapy.
  • To reduce treatment planning time, staff resources, and human error.
  • To improve the consistency of brachytherapy treatment plans.

Main Methods:

  • Developed an automated algorithm using thresholding and HDBSCAN clustering.
  • Retrospectively evaluated the algorithm on 10 cervix cancer patient datasets.
  • Compared automated contours with manual digitization using distance and dosimetric metrics.

Main Results:

  • Achieved close agreement between automated and manual digitization (mean contour disagreement: 0.3 mm).
  • Reported Hausdorff distances ≤1.0 mm and submillimeter agreement for applicator tip coordinates.
  • Observed minimal dosimetric differences (<1%) for critical structures and target volumes.
  • Demonstrated an average algorithm execution time of less than 30 seconds.

Conclusions:

  • Automated digitization of titanium tandem and ovoids applicators is feasible using thresholding and clustering.
  • Adoption of automated digitization can enhance treatment plan consistency.
  • Expected to significantly reduce the duration of brachytherapy treatment planning.