Alain Lalande

The advent of the 0.35 T MR-Linac (MRIdian, ViewRay) system in radiation therapy allows precise tumor targeting for moving lesions. However, the lack of an automatic volume segmentation function in the MR-Linac’s treatment planning system poses a challenge. In this paper, we propose a deep-learning-based multiorgan segmentation approach for the thoracic region, using EfficientNet as the backbone for the network architecture. The objectives of this approach include accurate segmentation of critical organs, such as the left and right lungs, the heart, the spinal cord, and the esophagus, essential for minimizing radiation toxicity during external radiation therapy. Our proposed approach, when evaluated on an internal dataset comprising 81 patients, demonstrated superior performance compared to other state-of-the-art methods. Specifically, the results for our approach with a 2.5D strategy were as follows: a dice similarity coefficient (DSC) of 0.820 ± 0.041, an intersection over union (IoU) of 0.725 ± 0.052, and a 3D Hausdorff distance (HD) of 10.353 ± 4.974 mm. Notably, the 2.5D strategy surpassed the 2D strategy in all three metrics, exhibiting higher DSC and IoU values, as well as lower HD values. This improvement strongly suggests that our proposed approach with the 2.5D strategy may hold promise in achieving more precise and accurate segmentations when compared to the conventional 2D strategy. Our work has practical implications in the improvement of treatment planning precision, aligning with the evolution of medical imaging and innovative strategies for multiorgan segmentation tasks.

Today, image-guided systems play a significant role in improving the outcome of diagnostic and therapeutic interventions. They provide crucial anatomical information during the procedure to decrease the size and the extent of the approach, to reduce intraoperative complications, and to increase accuracy, repeatability, and safety. Image-to-patient registration is the first step in image-guided procedures. It establishes a correspondence between the patient’s preoperative imaging and the intraoperative data. When it comes to the head-and-neck region, the presence of many sensitive structures such as the central nervous system or the neurosensory organs requires a millimetric precision. This review allows evaluating the characteristics and the performances of different registration methods in the head-and-neck region used in the operation room from the perspectives of accuracy, invasiveness, and processing times. Our work led to the conclusion that invasive marker-based methods are still considered as the gold standard of image-to-patient registration. The surface-based methods are recommended for faster procedures and applied on the surface tissues especially around the eyes. In the near future, computer vision technology is expected to enhance these systems by reducing human errors and cognitive load in the operating room.