An Automatic Framework for Segmentation of Brain Tumours at Follow-up Scans after Radiation Therapy*

Brain metastasis is the most common intracranial malignancy with a poor overall survival (OS) after treatment. The standard stereotactic radiation therapy (SRT) planning procedure for brain metastasis requires delineating the tumour volume on magnetic resonance (MR) images. MR images are also acquired at multiple follow-up scans after SRT to monitor the treatment outcome through measuring changes in the physical dimensions of the tumour. Such measurements require manual segmentation of the tumour volume on multiple slices of several follow-up images which is tedious and impedes the SRT evaluation work flow considerably. In this study, an automatic framework was proposed to segment the tumour volume on longitudinal MR images acquired at standard follow-up scans after SRT. The multi-step segmentation framework was based on region growing and morphological snakes models that applied the standard SRT planning tumour contour as a basis to approximate the tumour shape and location at each follow-up scan for an accurate automatic segmentation of tumour volume. The framework was evaluated using the MR imaging data acquired from five patients prior to and at three follow-up scans after SRT. The preliminary results indicated that the Dice similarity coefficient between the ground truth tumour masks and their automatically segmented counterparts ranged between 0.84 and 0.90, while the average Dice coefficient for all the follow-up scans was 0.88. The results obtained implied a good potential of the proposed framework for being incorporated into the SRT treatment planning and evaluation systems as well as outcome prediction models.