Combining watershed and graph cuts methods to segment organs at risk in radiotherapy

摘要

Computer-aided segmentation of anatomical structures in medical images is a valuable tool for efficient radiation therapy planning (RTP). As delineation errors highly affect the radiation oncology treatment, it is crucial to delineate geometric structures accurately. In this paper, a semi-automatic segmentation approach for computed tomography (CT) images, based on watershed and graph-cuts methods, is presented. The watershed pre-segmentation groups small areas of similar intensities in homogeneous labels, which are subsequently used as input for the graph-cuts algorithm. This methodology does not require of prior knowledge of the structure to be segmented; even so, it performs well with complex shapes and low intensity. The presented method also allows the user to add foreground and background strokes in any of the three standard orthogonal views - axial, sagittal or coronal - making the interaction with the algorithm easy and fast. Hence, the segmentation information is propagated within the whole volume, providing a spatially coherent result. The proposed algorithm has been evaluated using 9 CT volumes, by comparing its segmentation performance over several organs -lungs, liver, spleen, heart and aorta - to those of manual delineation from experts. A Dice's coefficient higher than 0.89 was achieved in every case. That demonstrates that the proposed approach works well for all the anatomical structures analyzed. Due to the quality of the results, the introduction of the proposed approach in the RTP process will be a helpful tool for organs at risk (OARs) segmentation.