CT-based auto-segmentation of multiple target volumes for all-in-one radiotherapy in rectal cancer patients
Abstract Background This study aimed to evaluate the clinical feasibility and performance of CT-based auto-segmentation models integrated into an All-in-One radiotherapy workflow for rectal cancer. Methods This study included 312 rectal cancer patients, with 272 used to train three nnU-Net models fo...
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| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-08-01
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| Series: | Radiation Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13014-025-02694-9 |
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| Summary: | Abstract Background This study aimed to evaluate the clinical feasibility and performance of CT-based auto-segmentation models integrated into an All-in-One radiotherapy workflow for rectal cancer. Methods This study included 312 rectal cancer patients, with 272 used to train three nnU-Net models for CTV45, CTV50, and GTV segmentation, and 40 for evaluation across one internal (n = 10), one clinical AIO (n = 10), and two external cohorts (n = 10 each). Segmentation accuracy (DSC, HD, HD95, ASSD, ASD) and time efficiency were assessed. Results In the internal testing set, mean DSC of CTV45, CTV50, and GTV were 0.90, 0.86, and 0.71; HD were 17.08, 25.48, and 79.59 mm; HD 95 were 4.89, 7.33, and 56.49 mm; ASSD were 1.23, 1.90, and 6.69 mm; and ASD were 1.24, 1.58, and 11.61 mm. Auto-segmentation reduced manual delineation time by 63.3–88.3% (p < 0.0001). In clinical practice, average DSC of CTV45, CTV50 and GTV were 0.93, 0.88, and 0.78; HD were 13.56, 23.84, and 35.38 mm; HD 95 were 3.33, 6.46, and 21.34 mm; ASSD were 0.78, 1.49, and 3.30 mm; and ASD were 0.74, 1.18, and 2.13 mm. The results from the multi-center testing also showed applicability of these models, since the average DSC of CTV45 and GTV were 0.84 and 0.80 respectively. Conclusions The models demonstrated high accuracy and clinical utility, effectively streamlining target volume delineation and reducing manual workload in routine practice. Trial registration The study protocol was approved by the Institutional Review Board of Peking University Third Hospital (Approval No. (2024) Medical Ethics Review No. 182-01). |
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| ISSN: | 1748-717X |