title: Volumetric CT-based segmentation of NSCLC using 3D-Slicer.
abstract: Accurate volumetric assessment in non-small cell lung cancer (NSCLC) is critical for adequately informing treatments. In this study we assessed the clinical relevance of a semiautomatic computed tomography (CT)-based segmentation method using the competitive region-growing based algorithm, implemented in the free and public available 3D-Slicer software platform. We compared the 3D-Slicer segmented volumes by three independent observers, who segmented the primary tumour of 20 NSCLC patients twice, to manual slice-by-slice delineations of five physicians. Furthermore, we compared all tumour contours to the macroscopic diameter of the tumour in pathology, considered as the "gold standard". The 3D-Slicer segmented volumes demonstrated high agreement (overlap fractions > 0.90), lower volume variability (p = 0.0003) and smaller uncertainty areas (p = 0.0002), compared to manual slice-by-slice delineations. Furthermore, 3D-Slicer segmentations showed a strong correlation to pathology (r = 0.89, 95%CI, 0.81-0.94). Our results show that semiautomatic 3D-Slicer segmentations can be used for accurate contouring and are more stable than manual delineations. Therefore, 3D-Slicer can be employed as a starting point for treatment decisions or for high-throughput data mining research, such as Radiomics, where manual delineating often represent a time-consuming bottleneck.
authors.affiliation: 1] Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA [2] Department of Radiation Oncology (MAASTRO), GROW Research Institute, Maastricht University, Maastricht, the Netherlands [3].
authors.forename: Emmanuel Rios
authors.initials: ER
authors.lastname: Velazquez
authors.affiliation: 1] Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA [2] Department of Radiation Oncology (MAASTRO), GROW Research Institute, Maastricht University, Maastricht, the Netherlands [3].
authors.forename: Chintan
authors.initials: C
authors.lastname: Parmar
authors.affiliation: 1] Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA [2] University of Massachusetts, Lowell, MA, USA.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Jermoumi
authors.affiliation: Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Raymond H
authors.initials: RH
authors.lastname: Mak
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW Research Institute, Maastricht University, Maastricht, the Netherlands.
authors.forename: Angela
authors.initials: A
authors.lastname: van Baardwijk
authors.affiliation: Department of Radiology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Fiona M
authors.initials: FM
authors.lastname: Fennessy
authors.affiliation: Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: John H
authors.initials: JH
authors.lastname: Lewis
authors.affiliation: Radiation Oncology, University Hospitals Leuven/KU Leuven, Leuven, Belgium.
authors.forename: Dirk
authors.initials: D
authors.lastname: De Ruysscher
authors.affiliation: Department of Radiology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Ron
authors.initials: R
authors.lastname: Kikinis
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW Research Institute, Maastricht University, Maastricht, the Netherlands.
authors.forename: Philippe
authors.initials: P
authors.lastname: Lambin
authors.affiliation: 1] Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA [2] Department of Radiation Oncology (MAASTRO), GROW Research Institute, Maastricht University, Maastricht, the Netherlands.
authors.forename: Hugo J W L
authors.initials: HJ
authors.lastname: Aerts
mesh_terms: D000465:Algorithms; D014408:Biomarkers, Tumor; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis*; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008168:Lung / Q000473:pathology; D008175:Lung Neoplasms / Q000175:diagnosis*; D010363:Pattern Recognition, Automated / Q000379:methods; D049268:Positron-Emission Tomography / Q000379:methods; D012984:Software
chemical_list: D014408:Biomarkers, Tumor