AUTOMATED SKIN SEGMENTATION IN ULTRASONIC EVALUATION OF SKIN TOXICITY IN BREAST CANCER RADIOTHERAPY
AUTOMATED SKIN SEGMENTATION IN ULTRASONIC EVALUATION OF SKIN TOXICITY IN BREAST CANCER RADIOTHERAPY
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DOI：
10.1016/j.ultrasmedbio.2013.04.006
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发表时间：
2013-11-01
影响因子：
2.9
通讯作者：
Liu, Tian
中科院分区：
文献类型：
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作者：
Gao, Yi;Tannenbaum, Allen;Liu, Tian
皮肤毒性是乳腺癌放射治疗最常见的副作用，会损害许多乳腺癌幸存者的生活质量。我们和其他研究人员最近发现定量超声作为皮肤毒性评估工具是有效的。虽然比标准临床评估（目视观察和触诊）更可靠，但目前基于超声的皮肤毒性测量程序需要在每个超声 B 模式图像上手动描绘皮肤层（即表皮-真皮和真皮-皮下界面）。手动皮肤分割既耗时又主观。此外，辐射引起的皮肤损伤可能会降低真皮和皮下组织之间的图像对比度，从而增加勾画的难度。因此，我们开发了一种基于活动轮廓模型的自动皮肤分割工具（ASST），并进行了两个重大修改：（i）所提出的算法引入了一种新颖的双曲线方案用于双皮肤层提取，而不是原始的单活动轮廓方法。 (ii) 与之前的参数算法不同，所提出的算法基于几何轮廓框架。该 ASST 算法在包含 730 张超声乳腺图像（23 名患者的 73 项超声研究）的乳腺癌图像数据库上进行了测试。我们将 ASST 获得的皮肤分割结果与两名医生执行的手动轮廓进行比较。 ASST 测量值与每位医生测量值之间的皮肤厚度平均百分比差异小于 5%（分别为 4.8 +/- 17.8% 和 -3.8 +/- 21.1%）。总之，我们开发了一种自动皮肤分割方法，可确保客观评估辐射引起的皮肤厚度变化。我们的超声技术提供了一个独特的机会，以比目前临床上使用的主观评估更有意义和可重复的方式量化组织损伤。 （电子邮件：tliu34@emory.edu） (C) 2013 年世界超声医学与生物学联合会。
Skin toxicity is the most common side effect of breast cancer radiotherapy and impairs the quality of life of many breast cancer survivors. We, along with other researchers, have recently found quantitative ultrasound to be effective as a skin toxicity assessment tool. Although more reliable than standard clinical evaluations (visual observation and palpation), the current procedure for ultrasound-based skin toxicity measurements requires manual delineation of the skin layers (i.e., epidermis-dermis and dermis-hypodermis interfaces) on each ultrasound B-mode image. Manual skin segmentation is time consuming and subjective. Moreover, radiation-induced skin injury may decrease image contrast between the dermis and hypodermis, which increases the difficulty of delineation. Therefore, we have developed an automatic skin segmentation tool (ASST) based on the active contour model with two significant modifications: (i) The proposed algorithm introduces a novel dual-curve scheme for the double skin layer extraction, as opposed to the original single active contour method. (ii) The proposed algorithm is based on a geometric contour framework as opposed to the previous parametric algorithm. This ASST algorithm was tested on a breast cancer image database of 730 ultrasound breast images (73 ultrasound studies of 23 patients). We compared skin segmentation results obtained with the ASST with manual contours performed by two physicians. The average percentage differences in skin thickness between the ASST measurement and that of each physician were less than 5% (4.8 +/- 17.8% and -3.8 +/- 21.1%, respectively). In summary, we have developed an automatic skin segmentation method that ensures objective assessment of radiation-induced changes in skin thickness. Our ultrasound technology offers a unique opportunity to quantify tissue injury in a more meaningful and reproducible manner than the subjective assessments currently employed in the clinic. (E-mail: tliu34@emory.edu) (C) 2013 World Federation for Ultrasound in Medicine & Biology.