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In radiation therapy, the accurate delineation of gross tumor volume (GTV) is crucial for treatment planning. However, it is challenging for head and neck cancer (HNC) due to the morphology complexity of various organs in the head, low targets to background contrast and potential artifacts on conventional planning CT images. Thus, manual delineation of GTV on anatomical images is extremely time consuming and suffers from inter-observer variability that leads to planning uncertainty. With the wide use of PET/CT imaging in oncology, complementary functional and anatomical information can be utilized for tumor contouring and bring a significant advantage for radiation therapy planning. In this study, by taking advantage of multi-modality PET and CT images, we propose an automatic GTV segmentation framework based on deep learning for HNC. The backbone of this segmentation framework is based on 3D convolution with dense connections which enables a better information propagation and takes full advantage of the features extracted from multi-modality input images. We evaluate our proposed framework on a dataset including 250 HNC patients. Each patient receives both planning CT and PET/CT imaging before radiation therapy. Manually delineated GTV contours by radiation oncologists are used as ground truth in this study. To further investigate the advantage of our proposed Dense-Net framework, we also compared with the framework using 3D U-Net which is the state-of-the-art in segmentation tasks. Meanwhile, for each frame, the performance comparison between single modality input (PET or CT image) and multi-modality input (both PET/CT) is conducted. Dice coefficient, mean surface distance (MSD), 95th-percentile Hausdorff distance (HD95) and displacement of mass centroid (DMC) are calculated for quantitative evaluation. The dataset is split into train (140 patients), validation (35 patients) and test (75 patients) groups to optimize the network. Based on the results on independent test group, our proposed multi-modality Dense-Net (Dice 0.73) shows better performance than the compared network (Dice 0.71). Furthermore, the proposed Dense-Net structure has less trainable parameters than the 3D U-Net, which reduces the prediction variability. In conclusion, our proposed multi-modality Dense-Net can enable satisfied GTV segmentation for HNC using multi-modality images and yield superior performance than conventional methods. Our proposed method provides an automatic, fast and consistent solution for GTV segmentation and shows potentials to be generally applied for radiation therapy planning of a variety of cancer (e.g. lung, sarcoma, liver and so on).
This article was published in the following journal.
Name: Physics in medicine and biology
To analyze two cohorts of locally advanced head and neck cancer (LAHNC) patients treated with two schedules of hypofractionated radiotherapy and 5 versus 3 mm clinical target volume-planning target vo...
18 F-fluorodeoxyglucose (FDG) positron emission tomography (PET) is now a standard diagnostic imaging test performed in patients with head and neck cancer for staging, re-staging, radiotherapy plannin...
A comparison of dose distributions in gross tumor volume between boron neutron capture therapy alone and combined boron neutron capture therapy plus intensity modulation radiation therapy for head and neck cancer.
Nine patients with recurrent head and neck (H&N) cancer received boron neutron capture therapy (BNCT) in one fraction at the Tsing-Hua Open pool reactor (THOR) utilizing the THORplan treatment plannin...
Characterizing tumor heterogeneity with textural indices extracted from 18F-fluorodeoxyglucose positron emission tomography (FDG PET/CT) is of growing interest in oncology. Several series showed promi...
Cancer stem cells (CSCs) and hypoxia are key contributors towards radioresistance and they influence the choice of radiotherapy schedule for optimal tumour control. Since hypofractionation is becoming...
Cone Beam Computed Tomography (CBCT) has been used to assess the volume of the maxillary sinus using the manual and semi-automatic segmentation. The majority of researches stressed on the ...
Patients with head and neck cancer will be imaged with PET scan and CT scan in order to determine areas of the tumour that are hypoxic. It is hypothesized that PET /CT will provide inform...
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This study investigates if head and neck squamous cell carcinoma can be tracked with cell-free tumor DNA, RNA or HPV-DNA, in blood samples from patients referred with suspicion of cancer, ...
This pilot clinical trial studies the effects of a low carbohydrate diet on tumor metabolism in patients with head and neck cancer. A low carbohydrate diet may reduce the metabolic activit...
Soft tissue tumors or cancer arising from the mucosal surfaces of the LIP; oral cavity; PHARYNX; LARYNX; and cervical esophagus. Other sites included are the NOSE and PARANASAL SINUSES; SALIVARY GLANDS; THYROID GLAND and PARATHYROID GLANDS; and MELANOMA and non-melanoma skin cancers of the head and neck. (from Holland et al., Cancer Medicine, 4th ed, p1651)
Radiotherapy given to augment some other form of treatment such as surgery or chemotherapy. Adjuvant radiotherapy is commonly used in the therapy of cancer and can be administered before or after the primary treatment.
In vivo method of screening investigative anticancer drugs and biologic response modifiers for individual cancer patients. Fresh tumor tissue is implanted under the kidney capsule of immunocompetent mice or rats; gross and histological assessments follow several days after tumor treatment in situ.
A tumor composed of cells resembling those of the hair matrix, which undergo 'mummification' and may calcify. It is a relatively uncommon tumor, which may occur at any age from infancy. The majority of patients are under 20, and females are affected more than males. The lesion is usually a solitary deep dermal or subcutaneous tumor 3-30 mm in diameter, situated in the head, neck, or upper extremity. (From Rook et al., Textbook of Dermatology, 4th ed, p2401)
Dissection in the neck to remove all disease tissues including cervical LYMPH NODES and to leave an adequate margin of normal tissue. This type of surgery is usually used in tumors or cervical metastases in the head and neck. The prototype of neck dissection is the radical neck dissection described by Crile in 1906.
Bladder Cancer Brain Cancer Breast Cancer Cancer Cervical Cancer Colorectal Head & Neck Cancers Hodgkin Lymphoma Leukemia Lung Cancer Melanoma Myeloma Ovarian Cancer Pancreatic Cancer ...
Complementary and Alternative Medicine
Alternative medicine are whole medical systems that did not fit with conventional medicine as they have completely different philosophies and ideas on the causes of disease, methods of diagnosis and approaches to treatment. Although often overlapping, co...