title: Atlas-based delineation of lymph node levels in head and neck computed tomography images.
abstract: OBJECTIVE
  Radiotherapy planning requires accurate delineations of the tumor and of the critical structures. Atlas-based segmentation has been shown to be very efficient to automatically delineate brain critical structures. We therefore propose to construct an anatomical atlas of the head and neck region.
  
  
  METHODS
  Due to the high anatomical variability of this region, an atlas built from a single image as for the brain is not adequate. We address this issue by building a symmetric atlas from a database of manually segmented images. First, we develop an atlas construction method and apply it to a database of 45 Computed Tomography (CT) images from patients with node-negative pharyngo-laryngeal squamous cell carcinoma manually delineated for radiotherapy. Then, we qualitatively and quantitatively evaluate the results generated by the built atlas based on Leave-One-Out framework on the database.
  
  
  RESULTS
  We present qualitative and quantitative results using this atlas construction method. The evaluation was performed on a subset of 12 patients among the original CT database of 45 patients. Qualitative results depict visually well delineated structures. The quantitative results are also good, with an error with respect to the best achievable results ranging from 0.196 to 0.404 with a mean of 0.253.
  
  
  CONCLUSIONS
  These results show the feasibility of using such an atlas for radiotherapy planning. Many perspectives are raised from this work ranging from extensive validation to the construction of several atlases representing sub-populations, to account for large inter-patient variabilities, and populations with node-positive tumors.
authors.affiliation: INRIA Sophia Antipolis - ASCLEPIOS Team, Sophia Antipolis Cedex, France. ocommowi@gmail.com
authors.forename: Olivier
authors.initials: O
authors.lastname: Commowick
authors.forename: Vincent
authors.initials: V
authors.lastname: Grégoire
authors.forename: Grégoire
authors.initials: G
authors.lastname: Malandain
mesh_terms: D001271:Atlases as Topic; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy*; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods*