LAUSR

Focal dose boost to dominant intraprostatic lesions (DILs) has recently been proposed for prostate radiation therapy. Accurate and fast delineation of the prostate and DILs is thus required during treatment planning. We propose a learning-based method using positron emission tomography (PET)/computed tomography (CT) images to automatically segment the prostate and its DILs. To enable end-to-end segmentation, a deep learning-based method, called cascaded regional-Net, is utilized. The first network, referred to as dual attention network (DAN), is used to segment the prostate via extracting comprehensive features from both PET and CT images. A second network, referred to as mask scoring regional convolutional neural network (MSR-CNN), is used to segment the DILs from the PET and CT within the prostate region. Scoring strategy is used to diminish the misclassification of the DILs. For DIL segmentation, the proposed cascaded regional-Net uses two steps to remove normal tissue regions, with the first step cropping images based on prostate segmentation and the second step using MSR-CNN to further locate the DILs. The binary masks of DILs and prostates of testing patients are generated from PET/CT by the trained network. To evaluate the proposed method, we retrospectively investigated 49 PET/CT datasets. On each dataset, the prostate and DILs were delineated by physicians and set as the ground truths and training targets. The proposed method was trained and evaluated using a five-fold cross-validation and a hold-out test. The mean surface distance and DSC values were 0.666±0.696mm and 0.932±0.059 for the prostate and 1.209±1.954mm and 0.757±0.241 for the DILs among all 49 patients. The proposed method has demonstrated great potential for improving the efficiency and reducing the observer variability of prostate and DIL contouring for DIL focal boost prostate radiation therapy.