Evidence map›Paper›PMID 34765748›Full record

ArticleClinical and translational radiation oncology2022

Evaluation of deep learning-based multiparametric MRI oropharyngeal primary tumor auto-segmentation and investigation of input channel effects: Results from a prospective imaging registry.

Kareem A Wahid, Sara Ahmed, Renjie He, Lisanne V van Dijk, Jonas Teuwen, Brigid A McDonald, Vivian Salama, Abdallah S R Mohamed, Travis Salzillo, Cem Dede and 4 more

Open access · goldAbstract read
In one paragraph

Article in Clinical and translational radiation oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
42citing papers in PubMed, 2 pooled it
5.8field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

42 citing papers in PubMed, 2 syntheses or guidelines pooled it, 57 citations in OpenAlex.

  1. Deep learning in MRI-guided radiation therapy: A systematic review.Journal of applied clinical medical physics · 2024
    Pooled it
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  8. A Coarse-to-Fine Framework for Mid-Radiotherapy Head and Neck Cancer MRI Segmentation.Head and Neck Tumor Segmentation for MR-Guided Applications : First MICCAI Challenge, HNTS-MRG 2024, held in conjunction with MICCAI 2024, Marrakesh, Morocco, October 17, 2024, proceedings · 2025
    Article
  9. Head and Neck Tumor Segmentation Using Pre-RT MRI Scans and Cascaded DualUNet.Head and Neck Tumor Segmentation for MR-Guided Applications : First MICCAI Challenge, HNTS-MRG 2024, held in conjunction with MICCAI 2024, Marrakesh, Morocco, October 17, 2024, proceedings · 2025
    Article
  10. Gradient Map-Assisted Head and Neck Tumor Segmentation: A Pre-RT to Mid-RT Approach in MRI-Guided Radiotherapy.Head and Neck Tumor Segmentation for MR-Guided Applications : First MICCAI Challenge, HNTS-MRG 2024, held in conjunction with MICCAI 2024, Marrakesh, Morocco, October 17, 2024, proceedings · 2025
    Article
  11. Overview of the Head and Neck Tumor Segmentation for Magnetic Resonance Guided Applications (HNTS-MRG) 2024 Challenge.Head and Neck Tumor Segmentation for MR-Guided Applications : First MICCAI Challenge, HNTS-MRG 2024, held in conjunction with MICCAI 2024, Marrakesh, Morocco, October 17, 2024, proceedings · 2025
    Article
  12. Ensemble Deep Learning Models for Automated Segmentation of Tumor and Lymph Node Volumes in Head and Neck Cancer Using Pre- and Mid-Treatment MRI: Application of Auto3DSeg and SegResNet.Head and Neck Tumor Segmentation for MR-Guided Applications : First MICCAI Challenge, HNTS-MRG 2024, held in conjunction with MICCAI 2024, Marrakesh, Morocco, October 17, 2024, proceedings · 2025
    Article
  13. Assessing Self-supervised xLSTM-UNet Architectures for Head and Neck Tumor Segmentation in MR-Guided Applications.Head and Neck Tumor Segmentation for MR-Guided Applications : First MICCAI Challenge, HNTS-MRG 2024, held in conjunction with MICCAI 2024, Marrakesh, Morocco, October 17, 2024, proceedings · 2025
    Article
  14. Head and Neck Gross Tumor Volume Automatic Segmentation Using PocketNet.Head and Neck Tumor Segmentation for MR-Guided Applications : First MICCAI Challenge, HNTS-MRG 2024, held in conjunction with MICCAI 2024, Marrakesh, Morocco, October 17, 2024, proceedings · 2025
    Article
  15. Deep Learning for Longitudinal Gross Tumor Volume Segmentation in MRI-Guided Adaptive Radiotherapy for Head and Neck Cancer.Head and Neck Tumor Segmentation for MR-Guided Applications : First MICCAI Challenge, HNTS-MRG 2024, held in conjunction with MICCAI 2024, Marrakesh, Morocco, October 17, 2024, proceedings · 2025
    Article
  16. MRI-Based Head and Neck Tumor Segmentation Using nnU-Net with 15-Fold Cross-Validation Ensemble.Head and Neck Tumor Segmentation for MR-Guided Applications : First MICCAI Challenge, HNTS-MRG 2024, held in conjunction with MICCAI 2024, Marrakesh, Morocco, October 17, 2024, proceedings · 2025
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 2 institutions in 2 countries.

Kareem A WahidDepartment of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX USA.
Sara AhmedDepartment of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX USA.
Renjie HeDepartment of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX USA.
Lisanne V van DijkDepartment of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX USA.
Jonas TeuwenDepartment of Medical Imaging, Radboud University Medical Centre, Nijmegen, The Netherlands.
Brigid A McDonaldDepartment of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX USA.
Vivian SalamaDepartment of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX USA.
Abdallah S R MohamedDepartment of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX USA.
Travis SalzilloDepartment of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX USA.
Cem DedeDepartment of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX USA.
Nicolette TakuDepartment of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX USA.
Stephen Y LaiDepartment of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, TX USA.
Clifton D FullerDepartment of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX USA.
Mohamed A NaserDepartment of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX USA.
The University of Texas MD Anderson Cancer Center · USRadboud University Medical Center · NL

Funding

Tumor Evolution and Metastasis ProgramP30CA016672 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI DIANE BODURKA · 1985 to 2026
$290.8M
Targeting the p53 pathway for reversal of oral premalignancyP50CA097007 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI LEE, HO-YOUNG · 2002 to 2012
$26.1M
Development of functional magnetic resonance imaging-guided adaptive radiotherapy for head and neck cancer patients using novel MR-Linac deviceR01DE028290 · NIDCR · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI CHRISTODOULEAS, JOHN PAUL, FULLER, CLIFTON DAVID · 2019 to 2023
$4.3M
NRSA Training CoreTL1TR003169 · NCATS · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · PI CHANDRA, JOYA, FROST, JEFFREY A. · 2019 to 2023
$3.7M
Using Dynamic Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI) to Establish Objective Clinical Outcome Measures for Mandibular OsteoradionecrosisR01DE025248 · NIDCR · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI LAI, STEPHEN Y · 2016 to 2020
$2.9M
SMART-ACT: Spatial Methodologic Approaches for Risk Assessment and Therapeutic Adaptation in Cancer TreatmentR01CA214825 · NCI · UNIVERSITY OF ILLINOIS AT CHICAGO · PI CANAHUATE, GUADALUPE, FULLER, CLIFTON DAVID · 2017 to 2019
$1.1M
imaging Radiation-Associated Dysphagia (iRAD)R01CA218148 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI FULLER, CLIFTON DAVID, HUTCHESON, KATHERINE ARNOLD · 2017 to 2019
$810k
Fellow and Resident Radiation Oncology iNtensive Training in Imaging and Informatics to Empower Research Careers (FRONTI2ER)R25EB025787 · NIBIB · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI DAS, PRAJNAN, FULLER, CLIFTON DAVID · 2018 to 2022
$535k
Using Dynamic Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI) to Establish Objective Clinical Outcome Measures for Mandibular OsteoradionecrosisR56DE025248 · NIDCR · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI LAI, STEPHEN Y · 2015 to 2015
$470k
Diffusion-Weighted Imaging-Based Adaptive Replanning for the MR-LinacF31DE029093 · NIDCR · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI MCDONALD, BRIGID ANNE · 2019 to 2021
$91k
Multiparametric Magnetic Resonance Imaging Artificial Intelligence Pipeline for Oropharyngeal Cancer Radiotherapy Treatment GuidanceF31DE031502 · NIDCR · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI WAHID, KAREEM · 2021 to 2023
$68k
NCATS NIH HHS TL1 TR003169NCI NIH HHS P30 CA016672NCI NIH HHS P50 CA097007NCI NIH HHS R01 CA214825NCI NIH HHS R01 CA218148NIBIB NIH HHS R25 EB025787NIDCR NIH HHS F31 DE029093NIDCR NIH HHS F31 DE031502NIDCR NIH HHS R01 DE025248NIDCR NIH HHS R01 DE028290NIDCR NIH HHS R56 DE025248
6 · The paper itself

Abstract

background/purposeOropharyngeal cancer (OPC) primary gross tumor volume (GTVp) segmentation is crucial for radiotherapy. Multiparametric MRI (mpMRI) is increasingly used for OPC adaptive radiotherapy but relies on manual segmentation. Therefore, we constructed mpMRI deep learning (DL) OPC GTVp auto-segmentation models and determined the impact of input channels on segmentation performance. MATERIALS/

methodsGTVp ground truth segmentations were manually generated for 30 OPC patients from a clinical trial. We evaluated five mpMRI input channels (T2, T1, ADC, Ktrans, Ve). 3D Residual U-net models were developed and assessed using leave-one-out cross-validation. A baseline T2 model was compared to mpMRI models (T2 + T1, T2 + ADC, T2 + Ktrans, T2 + Ve, all five channels [ALL]) primarily using the Dice similarity coefficient (DSC). False-negative DSC (FND), false-positive DSC, sensitivity, positive predictive value, surface DSC, Hausdorff distance (HD), 95% HD, and mean surface distance were also assessed. For the best model, ground truth and DL-generated segmentations were compared through a blinded Turing test using three physician observers.

resultsModels yielded mean DSCs from 0.71 ± 0.12 (ALL) to 0.73 ± 0.12 (T2 + T1). Compared to the T2 model, performance was significantly improved for FND, sensitivity, surface DSC, HD, and 95% HD for the T2 + T1 model (p < 0.05) and for FND for the T2 + Ve and ALL models (p < 0.05). No model demonstrated significant correlations between tumor size and DSC (p > 0.05). Most models demonstrated significant correlations between tumor size and HD or Surface DSC (p < 0.05), except those that included ADC or Ve as input channels (p > 0.05). On average, there were no significant differences between ground truth and DL-generated segmentations for all observers (p > 0.05).

conclusionDL using mpMRI provides reasonably accurate segmentations of OPC GTVp that may be comparable to ground truth segmentations generated by clinical experts. Incorporating additional mpMRI channels may increase the performance of FND, sensitivity, surface DSC, HD, and 95% HD, and improve model robustness to tumor size.

Identifiers

PMID34765748
PMCPMC8570930
OpenAlexW3206830804

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.