Outlines to outcomes : Second-generation AI auto-contouring for radiotherapy

体外放射治疗（RT）是现代癌症治疗的基石，为英国50%的癌症患者提供。RT计划涉及在患者的医学图像（例如CT扫描）上手动勾画要照射的目标和要避免的健康组织和器官。这种规划是耗时和技能密集型的，并且不可避免地存在观察者之间和观察者内部的差异。自动勾画器官轮廓的技术可以减少变异性并提高勾画轮廓过程的效率。继InnovateUK资助的上一个项目之后，Mirada Medical作为RT规划创新软件的成熟开发商，率先推出了其CE认证的基于AI的自动轮廓绘制解决方案DLCExpert。使用DLCExpert，临床医生可以比手动勾画更快、更一致地勾画出危险器官的轮廓，减少治疗计划所需的时间，让患者更快得到治疗。虽然比以前的技术有很大的改进，但市场上可用的AI解决方案是第一代，仍有改进的空间，在许多情况下仍需要编辑生成的轮廓。人工智能技术可以说还处于起步阶段。在这个项目中，我们寻求进一步推进最先进的技术，推动第二代解决方案，这将代表性能的又一步变化，并导致无需手动调整的自动轮廓，从而在癌症治疗途径中进一步节省时间。

External Beam Radiotherapy (RT) is a cornerstone of modern cancer treatment and is offered to 50% of cancer patients in the UK. RT planning involves manually outlining the target to be irradiated and healthy tissues and organs to be avoided on medical images of the patient (such as CT scans). This planning is time-consuming and skill-intensive, and there is inevitable inter- and intra-observer variation. Technology to automatically contour (auto-contouring) organs can reduce variability and improve efficiency of the contouring process. Following on from a previous project funded by InnovateUK, Mirada Medical, as an established developer of innovative software in RT planning, was first-to-market with their CE marked AI-based auto-contouring solution, DLCExpert. With the use of DLCExpert, clinicians can contour organs-at-risk faster and more consistently than with manual contouring reducing the time required for treatment planning and allowing patients to be treated sooner.While substantially better than the previous class of technology, the AI solutions available on the market are first generation and still have room for improvement, with editing of the contours produced still being required in many instances. AI technology could be considered to still be in its infancy. In this project, we seek to further advance the state-of-the-art, pushing towards a second-generation solution which would represent another step change in performance and lead to auto-contouring that requires no manual adjustment, thus providing further time-saving in the cancer treatment pathway.