title: Dentalmaps: automatic dental delineation for radiotherapy planning in head-and-neck cancer.
abstract: OBJECTIVE
  To propose an automatic atlas-based segmentation framework of the dental structures, called Dentalmaps, and to assess its accuracy and relevance to guide dental care in the context of intensity-modulated radiotherapy.
  
  
  METHODS
  A multi-atlas-based segmentation, less sensitive to artifacts than previously published head-and-neck segmentation methods, was used. The manual segmentations of a 21-patient database were first deformed onto the query using nonlinear registrations with the training images and then fused to estimate the consensus segmentation of the query.
  
  
  RESULTS
  The framework was evaluated with a leave-one-out protocol. The maximum doses estimated using manual contours were considered as ground truth and compared with the maximum doses estimated using automatic contours. The dose estimation error was within 2-Gy accuracy in 75% of cases (with a median of 0.9 Gy), whereas it was within 2-Gy accuracy in 30% of cases only with the visual estimation method without any contour, which is the routine practice procedure.
  
  
  CONCLUSIONS
  Dose estimates using this framework were more accurate than visual estimates without dental contour. Dentalmaps represents a useful documentation and communication tool between radiation oncologists and dentists in routine practice. Prospective multicenter assessment is underway on patients extrinsic to the database.
authors.affiliation: Department of Radiation Oncology/Institut de biologie et developpement du cancer (IBDC) centre national de la recherche scientifique (CNRS) unite mixte de recherche (UMR) 6543, Cancer Center Antoine-Lacassagne, University of Nice Sophia-Antipolis, Nice Cedex, France. jthariat@hotmail.com
authors.forename: Juliette
authors.initials: J
authors.lastname: Thariat
authors.forename: Liliane
authors.initials: L
authors.lastname: Ramus
authors.forename: Philippe
authors.initials: P
authors.lastname: Maingon
authors.forename: Guillaume
authors.initials: G
authors.lastname: Odin
authors.forename: Vincent
authors.initials: V
authors.lastname: Gregoire
authors.forename: Vincent
authors.initials: V
authors.lastname: Darcourt
authors.forename: Nicolas
authors.initials: N
authors.lastname: Guevara
authors.forename: Marie-Helene
authors.initials: MH
authors.lastname: Orlanducci
authors.forename: Serge
authors.initials: S
authors.lastname: Marcie
authors.forename: Gilles
authors.initials: G
authors.lastname: Poissonnet
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Marcy
authors.forename: Alex
authors.initials: A
authors.lastname: Bozec
authors.forename: Olivier
authors.initials: O
authors.lastname: Dassonville
authors.forename: Laurent
authors.initials: L
authors.lastname: Castillo
authors.forename: Francois
authors.initials: F
authors.lastname: Demard
authors.forename: Jose
authors.initials: J
authors.lastname: Santini
authors.forename: Gregoire
authors.initials: G
authors.lastname: Malandain
mesh_terms: D003731:Dental Caries / Q000517:prevention & control; D003813:Dentistry; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D033183:Interdisciplinary Communication; D008334:Mandible / Q000000981:diagnostic imaging* / Q000528:radiation effects; D008437:Maxilla / Q000000981:diagnostic imaging* / Q000528:radiation effects; D020714:Maximum Tolerated Dose; D008488:Medical Illustration; D010025:Osteoradionecrosis / Q000517:prevention & control; D018787:Radiation Oncology; D019252:Radiography, Dental, Digital / Q000379:methods*; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods*; D014070:Tooth / Q000000981:diagnostic imaging* / Q000528:radiation effects