3D Lightweight Network for Simultaneous Registration and Segmentation of Organs-at-Risk in CT Images of Head and Neck Cancer.

Image-guided radiation therapy (IGRT) is the most effective treatment for head and neck cancer. The successful implementation of IGRT requires accurate delineation of organ-at-risk (OAR) in the computed tomography (CT) images. In routine clinical practice, OARs are manually segmented by oncologists, which is time-consuming, laborious, and subjective. To assist oncologists in OAR contouring, we proposed a three-dimensional (3D) lightweight framework for simultaneous OAR registration and segmentation. The registration network was designed to align a selected OAR template to a new image volume for OAR localization. A region of interest (ROI) selection layer then generated ROIs of OARs from the registration results, which were fed into a multiview segmentation network for accurate OAR segmentation. To improve the performance of registration and segmentation networks, a centre distance loss was designed for the registration network, an ROI classification branch was employed for the segmentation network, and further, context information was incorporated to iteratively promote both networks' performance. The segmentation results were further refined with shape information for final delineation. We evaluated registration and segmentation performances of the proposed framework using three datasets. On the internal dataset, the Dice similarity coefficient (DSC) of registration and segmentation was 69.7% and 79.6%, respectively. In addition, our framework was evaluated on two external datasets and gained satisfactory performance. These results showed that the 3D lightweight framework achieved fast, accurate and robust registration and segmentation of OARs in head and neck cancer. The proposed framework has the potential of assisting oncologists in OAR delineation.