Automatic Segmentation of the Prostate on CT Images Using Deep Neural Networks (DNN)

Purpose: Recent advances in deep neural networks (DNNs) have unlocked opportunities for their application for automatic image segmentation. We have evaluated a DNN-based algorithm for automatic segmentation of the prostate gland on a large cohort of patient images. Methods and Materials: Planning-CT data sets for 1114 patients with prostate cancer were retrospectively selected and divided into 2 groups. Group A contained 1104 data sets, with 1 physician-generated prostate gland contour for each data set. Among these image sets, 771 were used for training, 193 for validation, and 140 for testing. Group B contained 10 data sets, each including prostate contours delineated by 5 independent physicians and a consensus contour generated using the STAPLE method in the CERR software package. All images were resampled to a spatial resolution of 1 x 1 x 1.5 mm. A region (128 x 128 x 64 voxels) containing the prostate was selected to train a DNN. The best-performing model on the validation data sets was used to segment the prostate on all testing images. Results were compared between DNN and physician-generated contours using the Dice similarity coefficient, Hausdorff distances, regional contour distances, and center-of-mass distances. Results: The mean Dice similarity coefficients between DNN-based prostate segmentation and physician-generated contours for test data in Group A, Group B, and Group B-consensus were 0.85 +/- 0.06 (range, 0.65-0.93), 0.85 +/- 0.04 (range, 0.80-0.91), and 0.88 +/- 0.03 (range, 0.82-0.92), respectively. The Hausdorff distance was 7.0 +/- 3.5 mm, 7.3 +/- 2.0 mm, and 6.3 +/- 2.0 mm for Group A, Group B, and Group B-consensus, respectively. The mean center-of-mass distances for all 3 data set groups were within 5 mm. Conclusions: A DNN-based algorithm was used to automatically segment the prostate for a large cohort of patients with prostate cancer. DNN-based prostate segmentations were compared to the consensus contour for a smaller group of patients; the agreement between DNN segmentations and consensus contour was similar to the agreement reported in a previous study. Clinical use of DNNs is promising, but further investigation is warranted. (C) 2019 Elsevier Inc. All rights reserved.