title: MRI definition of target volumes using fuzzy logic method for three-dimensional conformal radiation therapy.
abstract: OBJECTIVE
  Three-dimensional (3D) volume determination is one of the most important problems in conformal radiation therapy. Techniques of volume determination from tomographic medical imaging are usually based on two-dimensional (2D) contour definition with the result dependent on the segmentation method used, as well as on the user's manual procedure. The goal of this work is to describe and evaluate a new method that reduces the inaccuracies generally observed in the 2D contour definition and 3D volume reconstruction process.
  
  
  METHODS
  This new method has been developed by integrating the fuzziness in the 3D volume definition. It first defines semiautomatically a minimal 2D contour on each slice that definitely contains the volume and a maximal 2D contour that definitely does not contain the volume. The fuzziness region in between is processed using possibility functions in possibility theory. A volume of voxels, including the membership degree to the target volume, is then created on each slice axis, taking into account the slice position and slice profile. A resulting fuzzy volume is obtained after data fusion between multiorientation slices. Different studies have been designed to evaluate and compare this new method of target volume reconstruction and a classical reconstruction method. First, target definition accuracy and robustness were studied on phantom targets. Second, intra- and interobserver variations were studied on radiosurgery clinical cases.
  
  
  RESULTS
  The absolute volume errors are less than or equal to 1.5% for phantom volumes calculated by the fuzzy logic method, whereas the values obtained with the classical method are much larger than the actual volumes (absolute volume errors up to 72%). With increasing MRI slice thickness (1 mm to 8 mm), the phantom volumes calculated by the classical method are increasing exponentially with a maximum absolute error up to 300%. In contrast, the absolute volume errors are less than 12% for phantom volumes calculated by the fuzzy logic method. On radiosurgery clinical cases, target volumes defined by the fuzzy logic method are about half of the size of volumes defined by the classical method. Also, intra- and interobserver variations slightly decrease with the fuzzy logic method, resulting in the definition of a better common volume fraction.
  
  
  CONCLUSIONS
  Our fuzzy logic method shows accurate, robust, and reproducible results on phantoms and clinical targets imaged on MRI.
authors.affiliation: Department of Radiotherapy, Centre Oscar Lambret, Lille, France.
authors.forename: Jean Michel
authors.initials: JM
authors.lastname: Caudrelier
authors.forename: Stephane
authors.initials: S
authors.lastname: Vial
authors.forename: David
authors.initials: D
authors.lastname: Gibon
authors.forename: Carine
authors.initials: C
authors.lastname: Kulik
authors.forename: Charles
authors.initials: C
authors.lastname: Fournier
authors.forename: Bernard
authors.initials: B
authors.lastname: Castelain
authors.forename: Bernard
authors.initials: B
authors.lastname: Coche-Dequeant
authors.forename: Jean
authors.initials: J
authors.lastname: Rousseau
mesh_terms: D000465:Algorithms; D017143:Fuzzy Logic; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging; D015588:Observer Variation; D020266:Radiotherapy, Conformal / Q000379:methods*