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Title: TU-AB-202-11: Tumor Segmentation by Fusion of Multi-Tracer PET Images Using Copula Based Statistical Methods

Abstract

Purpose: Multi-tracer PET imaging is getting more attention in radiotherapy by providing additional tumor volume information such as glucose and oxygenation. However, automatic PET-based tumor segmentation is still a very challenging problem. We propose a statistical fusion approach to joint segment the sub-area of tumors from the two tracers FDG and FMISO PET images. Methods: Non-standardized Gamma distributions are convenient to model intensity distributions in PET. As a serious correlation exists in multi-tracer PET images, we proposed a new fusion method based on copula which is capable to represent dependency between different tracers. The Hidden Markov Field (HMF) model is used to represent spatial relationship between PET image voxels and statistical dynamics of intensities for each modality. Real PET images of five patients with FDG and FMISO are used to evaluate quantitatively and qualitatively our method. A comparison between individual and multi-tracer segmentations was conducted to show advantages of the proposed fusion method. Results: The segmentation results show that fusion with Gaussian copula can receive high Dice coefficient of 0.84 compared to that of 0.54 and 0.3 of monomodal segmentation results based on individual segmentation of FDG and FMISO PET images. In addition, high correlation coefficients (0.75 to 0.91) formore » the Gaussian copula for all five testing patients indicates the dependency between tumor regions in the multi-tracer PET images. Conclusion: This study shows that using multi-tracer PET imaging can efficiently improve the segmentation of tumor region where hypoxia and glucidic consumption are present at the same time. Introduction of copulas for modeling the dependency between two tracers can simultaneously take into account information from both tracers and deal with two pathological phenomena. Future work will be to consider other families of copula such as spherical and archimedian copulas, and to eliminate partial volume effect by considering dependency between neighboring voxels.« less

Authors:
;  [1];  [2];  [3]
  1. University of Rouen, Rouen, Normandy (France)
  2. Washington University School of Medicine, Saint Louis, MO (United States)
  3. Centre Henri-Becquerel, University de Rouen, Rouen, Normandy (France)
Publication Date:
OSTI Identifier:
22653961
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 43; Journal Issue: 6; Other Information: (c) 2016 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
60 APPLIED LIFE SCIENCES; 61 RADIATION PROTECTION AND DOSIMETRY; BIOMEDICAL RADIOGRAPHY; IMAGES; MARKOV PROCESS; NEOPLASMS; POSITRON COMPUTED TOMOGRAPHY; SIMULATION

Citation Formats

Lapuyade-Lahorgue, J, Ruan, S, Li, H, and Vera, P. TU-AB-202-11: Tumor Segmentation by Fusion of Multi-Tracer PET Images Using Copula Based Statistical Methods. United States: N. p., 2016. Web. doi:10.1118/1.4957433.
Lapuyade-Lahorgue, J, Ruan, S, Li, H, & Vera, P. TU-AB-202-11: Tumor Segmentation by Fusion of Multi-Tracer PET Images Using Copula Based Statistical Methods. United States. doi:10.1118/1.4957433.
Lapuyade-Lahorgue, J, Ruan, S, Li, H, and Vera, P. Wed . "TU-AB-202-11: Tumor Segmentation by Fusion of Multi-Tracer PET Images Using Copula Based Statistical Methods". United States. doi:10.1118/1.4957433.
@article{osti_22653961,
title = {TU-AB-202-11: Tumor Segmentation by Fusion of Multi-Tracer PET Images Using Copula Based Statistical Methods},
author = {Lapuyade-Lahorgue, J and Ruan, S and Li, H and Vera, P},
abstractNote = {Purpose: Multi-tracer PET imaging is getting more attention in radiotherapy by providing additional tumor volume information such as glucose and oxygenation. However, automatic PET-based tumor segmentation is still a very challenging problem. We propose a statistical fusion approach to joint segment the sub-area of tumors from the two tracers FDG and FMISO PET images. Methods: Non-standardized Gamma distributions are convenient to model intensity distributions in PET. As a serious correlation exists in multi-tracer PET images, we proposed a new fusion method based on copula which is capable to represent dependency between different tracers. The Hidden Markov Field (HMF) model is used to represent spatial relationship between PET image voxels and statistical dynamics of intensities for each modality. Real PET images of five patients with FDG and FMISO are used to evaluate quantitatively and qualitatively our method. A comparison between individual and multi-tracer segmentations was conducted to show advantages of the proposed fusion method. Results: The segmentation results show that fusion with Gaussian copula can receive high Dice coefficient of 0.84 compared to that of 0.54 and 0.3 of monomodal segmentation results based on individual segmentation of FDG and FMISO PET images. In addition, high correlation coefficients (0.75 to 0.91) for the Gaussian copula for all five testing patients indicates the dependency between tumor regions in the multi-tracer PET images. Conclusion: This study shows that using multi-tracer PET imaging can efficiently improve the segmentation of tumor region where hypoxia and glucidic consumption are present at the same time. Introduction of copulas for modeling the dependency between two tracers can simultaneously take into account information from both tracers and deal with two pathological phenomena. Future work will be to consider other families of copula such as spherical and archimedian copulas, and to eliminate partial volume effect by considering dependency between neighboring voxels.},
doi = {10.1118/1.4957433},
journal = {Medical Physics},
number = 6,
volume = 43,
place = {United States},
year = {Wed Jun 15 00:00:00 EDT 2016},
month = {Wed Jun 15 00:00:00 EDT 2016}
}
  • Purpose: In PET-guided adaptive radiotherapy (RT), changes in the metabolic activity at individual voxels cannot be derived until the duringtreatment CT images are appropriately registered to pre-treatment CT images. However, deformable image registration (DIR) usually does not preserve tumor volume. This may induce errors when comparing to the target. The aim of this study was to develop a DIR-integrated mechanical modeling technique to track radiation-induced metabolic changes on PET images. Methods: Three patients with non-small cell lung cancer (NSCLC) were treated with adaptive radiotherapy under RTOG 1106. Two PET/CT image sets were acquired 2 weeks before RT and 18 fractionsmore » after the start of treatment. DIR was performed to register the during-RT CT to the pre-RT CT using a B-spline algorithm and the resultant displacements in the region of tumor were remodeled using a hybrid finite element method (FEM). Gross tumor volume (GTV) was delineated on the during-RT PET/CT image sets and deformed using the 3D deformation vector fields generated by the CT-based registrations. Metabolic tumor volume (MTV) was calculated using the pre- and during–RT image set. The quality of the PET mapping was evaluated based on the constancy of the mapped MTV and landmark comparison. Results: The B-spline-based registrations changed MTVs by 7.3%, 4.6% and −5.9% for the 3 patients and the correspondent changes for the hybrid FEM method −2.9%, 1% and 6.3%, respectively. Landmark comparisons were used to evaluate the Rigid, B-Spline, and hybrid FEM registrations with the mean errors of 10.1 ± 1.6 mm, 4.4 ± 0.4 mm, and 3.6 ± 0.4 mm for three patients. The hybrid FEM method outperforms the B-Spline-only registration for patients with tumor regression Conclusion: The hybrid FEM modeling technique improves the B-Spline registrations in tumor regions. This technique may help compare metabolic activities between two PET/CT images with regressing tumors. The author gratefully acknowledges the financial support from the National Institutes of Health Grant.« less
  • Purpose: To evaluate the ability of a multiscale radiobiological model of tumor response to predict mid-treatment hypoxia images, based on pretreatment imaging of perfusion and hypoxia with [18-F]FMISO dynamic PET and glucose metabolism with [18-F]FDG PET. Methods: A mechanistic tumor control probability (TCP) radiobiological model describing the interplay between tumor cell proliferation and hypoxia (Jeong et al., PMB 2013) was extended to account for intra-tumor nutrient heterogeneity, dynamic cell migration due to nutrient gradients, and stromal cells. This extended model was tested on 10 head and neck cancer patients treated with chemoradiotherapy, randomly drawn from a larger MSKCC protocol involvingmore » baseline and mid-therapy dynamic PET scans. For each voxel, initial fractions of proliferative and hypoxic tumor cells were obtained by finding an approximate solution to a system of linear equations relating cell fractions to voxel-level FDG uptake, perfusion (FMISO K{sub 1}) and hypoxia (FMISO k{sub 3}). The TCP model then predicted their evolution over time up until the mid treatment scan. Finally, the linear model was reapplied to predict each lesion’s median hypoxia level (k{sub 3}[med,sim]) which in turn was compared to the FMISO k{sub 3}[med] measured at mid-therapy. Results: The average k3[med] of the tumors in pre-treatment scans was 0.0035 min{sup −1}, with an inter-tumor standard deviation of σ[pre]=0.0034 min{sup −1}. The initial simulated k{sub 3}[med,sim] of each tumor agreed with the corresponding measurements within 0.1σ[pre]. In 7 out of 10 lesions, the mid-treatment k{sub 3}[med,sim] prediction agreed with the data within 0.3σ[pre]. The remaining cases corresponded to the most extreme relative changes in k{sub 3}[med]. Conclusion: This work presents a method to personalize the prediction of a TCP model using pre-treatment kinetic imaging data, and validates the modeling of radiotherapy response by predicting changes in median hypoxia values during treatment. Variations from predicted response may be a useful biomarker, which should be further explored. Partially supported by NIH grant #1 R01 CA157770-01A1 and a grant from Varian Corporation.« less
  • Purpose: Accurate deformable image registration (DIR) between external beam radiotherapy (EBRT) and HDR brachytherapy (BT) CT images in cervical cancer is challenging. DSC has been evaluated only on the basis of the consistency of the structure, and its use does not guarantee an anatomically reasonable deformation. We evaluate the DIR accuracy for cervical cancer with DSC and anatomical landmarks using a 3D-printed pelvis phantom. Methods: A 3D-printed, deformable female pelvis phantom was created on the basis of the patient’s CT image. Urethane and silicon were used as materials for creating the uterus and bladder, respectively, in the phantom. We performedmore » DIR in two cases: case-A with a full bladder (170 ml) in both the EBRT and BT images and case-B with a full bladder in the BT image and a half bladder (100 ml) in the EBRT image. DIR was evaluated using DSCs and 70 uterus and bladder landmarks. A Hybrid intensity and structure DIR algorithm with two settings (RayStation) was used. Results: In the case-A, DSCs of the intensity-based DIR were 0.93 and 0.85 for the bladder and uterus, respectively, whereas those of hybrid-DIR were 0.98 and 0.96, respectively. The mean landmark error values of intensity-based DIR were 0.73±0.29 and 1.70±0.19 cm for the bladder and uterus, respectively, whereas those of Hybrid-DIR were 0.43±0.33 and 1.23±0.25 cm, respectively. In both cases, the Hybrid-DIR accuracy was better than the intensity-based DIR accuracy for both evaluation methods. However, for several bladder landmarks, the Hybrid-DIR landmark errors were larger than the corresponding intensity-based DIR errors (e.g., 2.26 vs 1.25 cm). Conclusion: Our results demonstrate that Hybrid-DIR can perform with a better accuracy than the intensity-based DIR for both DSC and landmark errors; however, Hybrid-DIR shows a larger landmark error for some landmarks because the technique focuses on both the structure and intensity.« less
  • Purpose: To improve agreement of predicted and measured positron emitter yields in patients, after proton irradiation for PET-based treatment verification, using a novel dual energy CT (DECT) tissue segmentation approach, overcoming known deficiencies from single energy CT (SECT). Methods: DECT head scans of 5 trauma patients were segmented and compared to existing decomposition methods with a first focus on the brain. For validation purposes, three brain equivalent solutions [water, white matter (WM) and grey matter (GM) – equivalent with respect to their reference carbon and oxygen contents and CT numbers at 90kVp and 150kVp] were prepared from water, ethanol, sucrosemore » and salt. The activities of all brain solutions, measured during a PET scan after uniform proton irradiation, were compared to Monte Carlo simulations. Simulation inputs were various solution compositions obtained from different segmentation approaches from DECT, SECT scans, and known reference composition. Virtual GM solution salt concentration corrections were applied based on DECT measurements of solutions with varying salt concentration. Results: The novel tissue segmentation showed qualitative improvements in %C for patient brain scans (ground truth unavailable). The activity simulations based on reference solution compositions agree with the measurement within 3–5% (4–8Bq/ml). These reference simulations showed an absolute activity difference between WM (20%C) and GM (10%C) to H2O (0%C) of 43 Bq/ml and 22 Bq/ml, respectively. Activity differences between reference simulations and segmented ones varied from −6 to 1 Bq/ml for DECT and −79 to 8 Bq/ml for SECT. Conclusion: Compared to the conventionally used SECT segmentation, the DECT based segmentation indicates a qualitative and quantitative improvement. In controlled solutions, a MC input based on DECT segmentation leads to better agreement with the reference. Future work will address the anticipated improvement of quantification accuracy in patients, comparing different tissue decomposition methods with an MR brain segmentation. Acknowledgement: DFG-MAP and HIT-Heidelberg Deutsche Forschungsgemeinschaft (MAP); Bundesministerium fur Bildung und Forschung (01IB13001)« less
  • Purpose: To investigate the effectiveness of atlas selection methods for improving atlas-based auto-contouring in radiotherapy planning. Methods: 275 H&N clinically delineated cases were employed as an atlas database from which atlases would be selected. A further 40 previously contoured cases were used as test patients against which atlas selection could be performed and evaluated. 26 variations of selection methods proposed in the literature and used in commercial systems were investigated. Atlas selection methods comprised either global or local image similarity measures, computed after rigid or deformable registration, combined with direct atlas search or with an intermediate template image. Workflow Boxmore » (Mirada-Medical, Oxford, UK) was used for all auto-contouring. Results on brain, brainstem, parotids and spinal cord were compared to random selection, a fixed set of 10 “good” atlases, and optimal selection by an “oracle” with knowledge of the ground truth. The Dice score and the average ranking with respect to the “oracle” were employed to assess the performance of the top 10 atlases selected by each method. Results: The fixed set of “good” atlases outperformed all of the atlas-patient image similarity-based selection methods (mean Dice 0.715 c.f. 0.603 to 0.677). In general, methods based on exhaustive comparison of local similarity measures showed better average Dice scores (0.658 to 0.677) compared to the use of either template image (0.655 to 0.672) or global similarity measures (0.603 to 0.666). The performance of image-based selection methods was found to be only slightly better than a random (0.645). Dice scores given relate to the left parotid, but similar results patterns were observed for all organs. Conclusion: Intuitively, atlas selection based on the patient CT is expected to improve auto-contouring performance. However, it was found that published approaches performed marginally better than random and use of a fixed set of representative atlases showed favourable performance. This research was funded via InnovateUK Grant 600277 as part of Eurostars Grant E!9297. DP,BS,MG,TK are employees of Mirada Medical Ltd.« less