PURPOSE

Accurate prostate segmentation is necessary for maximizing the effectiveness of radiation therapy of prostate cancer. However, manual segmentation from 3D CT images is very time-consuming and often causes large intra- and interobserver variations across clinicians. Many segmentation methods have been proposed to automate this labor-intensive process, but tedious manual editing is still required due to the limited performance. In this paper, the authors propose a new interactive segmentation method that can (1) flexibly generate the editing result with a few scribbles or dots provided by a clinician, (2) fast deliver intermediate results to the clinician, and (3) sequentially correct the segmentations from any type of automatic or interactive segmentation methods.

METHODS

The authors formulate the editing problem as a semisupervised learning problem which can utilize a priori knowledge of training data and also the valuable information from user interactions. Specifically, from a region of interest near the given user interactions, the appropriate training labels, which are well matched with the user interactions, can be locally searched from a training set. With voting from the selected training labels, both confident prostate and background voxels, as well as unconfident voxels can be estimated. To reflect informative relationship between voxels, location-adaptive features are selected from the confident voxels by using regression forest and Fisher separation criterion. Then, the manifold configuration computed in the derived feature space is enforced into the semisupervised learning algorithm. The labels of unconfident voxels are then predicted by regularizing semisupervised learning algorithm.

RESULTS

The proposed interactive segmentation method was applied to correct automatic segmentation results of 30 challenging CT images. The correction was conducted three times with different user interactions performed at different time periods, in order to evaluate both the efficiency and the robustness. The automatic segmentation results with the original average Dice similarity coefficient of 0.78 were improved to 0.865-0.872 after conducting 55-59 interactions by using the proposed method, where each editing procedure took less than 3 s. In addition, the proposed method obtained the most consistent editing results with respect to different user interactions, compared to other methods.

CONCLUSIONS

The proposed method obtains robust editing results with few interactions for various wrong segmentation cases, by selecting the location-adaptive features and further imposing the manifold regularization. The authors expect the proposed method to largely reduce the laborious burdens of manual editing, as well as both the intra- and interobserver variability across clinicians.