ArticleFrontiers in oncology2025
Clinical evaluation of atlas-based auto-segmentation for contouring pelvic CTVs in the treatment of anal cancer with FDG-PET-positive lymph node involvement.
Article in Frontiers in oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Current evidence on atlas-based auto-segmentation (ABS) in radiotherapy primarily addresses organs at risk, whereas its application for clinical target volume (CTV) delineation remains insufficiently explored. Additionally, the optimal number of datasets required for ABS atlases is debated. This study investigates ABS performance for automated CTV (aCTV) segmentation in anal cancer patients with Methods: A retrospective analysis was conducted on 51 anal cancer patients who underwent Results: Of the 51 patients, 27 (52.9%) had FDG-positive LN metastases. The mean DSI for atlas sizes of n = 10, 20, 30, 40, and 50 were 0.73, 0.78, 0.79, 0.79, and 0.80, respectively. A DSI ≥ 0.7 was achieved in 24 patients (88.9%) across all atlas sizes. The increase in DSI between n = 10 and n = 40 was statistically significant (Bonferroni-adjusted p < 0.05). Mean relative NCV and MCV ranged from 21.8-23.9% and 17.7-19.5% of the respective mCTV volume, with decreasing trends as atlas size increased. Segmentation inaccuracies predominantly occurred in the upper mesorectal and lower ischiorectal regions. Discussion: In conclusion, ABS facilitates the delineation of CTVs in anal cancer patients and improves contouring efficiency. However, manual correction by radiation oncologists remains necessary.
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