title: Systematic evaluation of three different commercial software solutions for automatic segmentation for adaptive therapy in head-and-neck, prostate and pleural cancer.
abstract: OBJECTIVE
  To validate, in the context of adaptive radiotherapy, three commercial software solutions for atlas-based segmentation.
  
  
  METHODS
  Fifteen patients, five for each group, with cancer of the Head&Neck, pleura, and prostate were enrolled in the study. In addition to the treatment planning CT (pCT) images, one replanning CT (rCT) image set was acquired for each patient during the RT course. Three experienced physicians outlined on the pCT and rCT all the volumes of interest (VOIs). We used three software solutions (VelocityAI 2.6.2 (V), MIM 5.1.1 (M) by MIMVista and ABAS 2.0 (A) by CMS-Elekta) to generate the automatic contouring on the repeated CT. All the VOIs obtained with automatic contouring (AC) were successively corrected manually. We recorded the time needed for: 1) ex novo ROIs definition on rCT; 2) generation of AC by the three software solutions; 3) manual correction of AC.To compare the quality of the volumes obtained automatically by the software and manually corrected with those drawn from scratch on rCT, we used the following indexes: overlap coefficient (DICE), sensitivity, inclusiveness index, difference in volume, and displacement differences on three axes (x, y, z) from the isocenter.
  
  
  RESULTS
  The time saved by the three software solutions for all the sites, compared to the manual contouring from scratch, is statistically significant and similar for all the three software solutions. The time saved for each site are as follows: about an hour for Head&Neck, about 40 minutes for prostate, and about 20 minutes for mesothelioma. The best DICE similarity coefficient index was obtained with the manual correction for: A (contours for prostate), A and M (contours for H&N), and M (contours for mesothelioma).
  
  
  CONCLUSIONS
  From a clinical point of view, the automated contouring workflow was shown to be significantly shorter than the manual contouring process, even though manual correction of the VOIs is always needed.
authors.affiliation: Agenzia Provinciale per la Protonterapia, Via F.lli Perini, 181, 38122, Trento, Italy.
authors.forename: Mariangela
authors.initials: M
authors.lastname: La Macchia
authors.forename: Francesco
authors.initials: F
authors.lastname: Fellin
authors.forename: Maurizio
authors.initials: M
authors.lastname: Amichetti
authors.forename: Marco
authors.initials: M
authors.lastname: Cianchetti
authors.forename: Stefano
authors.initials: S
authors.lastname: Gianolini
authors.forename: Vitali
authors.initials: V
authors.lastname: Paola
authors.forename: Antony J
authors.initials: AJ
authors.lastname: Lomax
authors.forename: Lamberto
authors.initials: L
authors.lastname: Widesott
mesh_terms: D000465:Algorithms; D001331:Automation; D001330:Electronic Data Processing; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008175:Lung Neoplasms / Q000532:radiotherapy*; D008297:Male; D010997:Pleural Neoplasms / Q000532:radiotherapy*; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D012372:ROC Curve; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D015203:Reproducibility of Results; D012984:Software; D014057:Tomography, X-Ray Computed / Q000379:methods