Multi-atlas-based automatic 3D segmentation for prostate brachytherapy in transrectal ultrasound images

One of the commonly used treatment methods for early-stage prostate cancer is brachytherapy. The standard of care for planning this procedure is segmentation of contours from transrectal ultrasound (TRUS) images, which closely follow the prostate boundary. This process is currently performed either manually or using semi-automatic techniques. This paper introduces a fully automatic segmentation algorithm which uses a priori knowledge of contours in a reference data set of TRUS volumes. A non-parametric deformable registration method is employed to transform the atlas prostate contours to a target image coordinates. All atlas images are sorted based on their registration results and the highest ranked registration results are selected for decision fusion. A Simultaneous Truth and Performance Level Estimation algorithm is utilized to fuse labels from registered atlases and produce a segmented target volume. In this experiment, 50 patient TRUS volumes are obtained and a leave-one-out study on TRUS volumes is reported. We also compare our results with a state-of-the-art semi-automatic prostate segmentation method that has been clinically used for planning prostate brachytherapy procedures and we show comparable accuracy and precision within clinically acceptable runtime.

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