RESUMEN
BACKGROUND AND PURPOSE: To investigate the performance of head-and-neck (HN) organs-at-risk (OAR) automatic segmentation (AS) using four atlas-based (ABAS) and two deep learning (DL) solutions. MATERIAL AND METHODS: All patients underwent iodine contrast-enhanced planning CT. Fourteen OAR were manually delineated. DL.1 and DL.2 solutions were trained with 63 mono-centric patients and > 1000 multi-centric patients, respectively. Ten and 15 patients with varied anatomies were selected for the atlas library and for testing, respectively. The evaluation was based on geometric indices (DICE coefficient and 95th percentile-Hausdorff Distance (HD95%)), time needed for manual corrections and clinical dosimetric endpoints obtained using automated treatment planning. RESULTS: Both DICE and HD95% results indicated that DL algorithms generally performed better compared with ABAS algorithms for automatic segmentation of HN OAR. However, the hybrid-ABAS (ABAS.3) algorithm sometimes provided the highest agreement to the reference contours compared with the 2 DL. Compared with DL.2 and ABAS.3, DL.1 contours were the fastest to correct. For the 3 solutions, the differences in dose distributions obtained using AS contours and AS + manually corrected contours were not statistically significant. High dose differences could be observed when OAR contours were at short distances to the targets. However, this was not always interrelated. CONCLUSION: DL methods generally showed higher delineation accuracy compared with ABAS methods for AS segmentation of HN OAR. Most ABAS contours had high conformity to the reference but were more time consuming than DL algorithms, especially when considering the computing time and the time spent on manual corrections.
