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A semi-automated workflow for cohort-wise preparation of radiotherapy data for dose-response modeling, including autosegmentation of organs at risk

Mövik, Louise ; Bäck, Anna ; Gunnarsson, Kerstin ; Gustafsson, Christian Jamtheim LU ; Hallqvist, Andreas and Pettersson, Niclas (2025) In Journal of Applied Clinical Medical Physics 26(7).
Abstract

Background: Preparing retrospective dose data for risk modeling using large study cohorts can be time consuming as it often requires patient-wise manual interventions. This is especially the case when considering organs at risk (OARs) not systematically delineated historically. Therefore, we aimed to develop and test a semi-automated workflow for cohort-wise preparation of radiotherapy data from the oncology information system (OIS), including OAR autosegmentation, for risk modeling purposes. Methods: A semi-automated workflow, including cohort-wise data extraction from a clinical OIS, cleanup, autosegmentation, quality controls (QCs), and data injection into a research OIS was iteratively developed using 106 patient cases. We evaluated... (More)

Background: Preparing retrospective dose data for risk modeling using large study cohorts can be time consuming as it often requires patient-wise manual interventions. This is especially the case when considering organs at risk (OARs) not systematically delineated historically. Therefore, we aimed to develop and test a semi-automated workflow for cohort-wise preparation of radiotherapy data from the oncology information system (OIS), including OAR autosegmentation, for risk modeling purposes. Methods: A semi-automated workflow, including cohort-wise data extraction from a clinical OIS, cleanup, autosegmentation, quality controls (QCs), and data injection into a research OIS was iteratively developed using 106 patient cases. We evaluated two deep learning (DL)-based methods and compared with four atlas-based methods for autosegmentation of the proximal bronchial tree (PBT), the heart, and the esophagus that were possible to integrate into the workflow. One method was an in-house DL-based model using OARs manually contoured by experts for 100 cases. Geometric and dosimetric agreements with manually contoured OARs were evaluated for 20 independent cases. The final workflow was tested on 50 independent cases. Results: The DL-based methods were better than the atlas-based at segmenting the PBT (mean Dice similarity coefficient (DSC) 0.81–0.83 versus 0.59–0.80) and the esophagus (mean DSC 0.76–0.77 versus 0.39–0.46). The methods performed similarly for the heart (mean DSC 0.90–0.95 (DL-based) and 0.84–0.90 (atlas-based)). Our in-house autosegmentation model had the highest mean DSC for all OARs. The final version of the workflow successfully prepared data for 80% of the test cases without case-specific manual interventions. Conclusions: The semi-automated workflow enabled efficient cohort-wise preparation of OIS data for risk modeling purposes. Our in-house DL-based segmentation model outperformed the other methods.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
automation, autosegmentation, large-scale studies, modeling
in
Journal of Applied Clinical Medical Physics
volume
26
issue
7
article number
e70152
publisher
American College of Medical Physics
external identifiers
  • pmid:40653785
  • scopus:105010681875
ISSN
1526-9914
DOI
10.1002/acm2.70152
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2025 The Author(s). Journal of Applied Clinical Medical Physics published by Wiley Periodicals, LLC on behalf of The American Association of Physicists in Medicine.
id
39d23faf-82aa-4770-9464-a139d888d22d
date added to LUP
2025-12-15 13:32:58
date last changed
2025-12-15 13:34:15
@article{39d23faf-82aa-4770-9464-a139d888d22d,
  abstract     = {{<p>Background: Preparing retrospective dose data for risk modeling using large study cohorts can be time consuming as it often requires patient-wise manual interventions. This is especially the case when considering organs at risk (OARs) not systematically delineated historically. Therefore, we aimed to develop and test a semi-automated workflow for cohort-wise preparation of radiotherapy data from the oncology information system (OIS), including OAR autosegmentation, for risk modeling purposes. Methods: A semi-automated workflow, including cohort-wise data extraction from a clinical OIS, cleanup, autosegmentation, quality controls (QCs), and data injection into a research OIS was iteratively developed using 106 patient cases. We evaluated two deep learning (DL)-based methods and compared with four atlas-based methods for autosegmentation of the proximal bronchial tree (PBT), the heart, and the esophagus that were possible to integrate into the workflow. One method was an in-house DL-based model using OARs manually contoured by experts for 100 cases. Geometric and dosimetric agreements with manually contoured OARs were evaluated for 20 independent cases. The final workflow was tested on 50 independent cases. Results: The DL-based methods were better than the atlas-based at segmenting the PBT (mean Dice similarity coefficient (DSC) 0.81–0.83 versus 0.59–0.80) and the esophagus (mean DSC 0.76–0.77 versus 0.39–0.46). The methods performed similarly for the heart (mean DSC 0.90–0.95 (DL-based) and 0.84–0.90 (atlas-based)). Our in-house autosegmentation model had the highest mean DSC for all OARs. The final version of the workflow successfully prepared data for 80% of the test cases without case-specific manual interventions. Conclusions: The semi-automated workflow enabled efficient cohort-wise preparation of OIS data for risk modeling purposes. Our in-house DL-based segmentation model outperformed the other methods.</p>}},
  author       = {{Mövik, Louise and Bäck, Anna and Gunnarsson, Kerstin and Gustafsson, Christian Jamtheim and Hallqvist, Andreas and Pettersson, Niclas}},
  issn         = {{1526-9914}},
  keywords     = {{automation; autosegmentation; large-scale studies; modeling}},
  language     = {{eng}},
  number       = {{7}},
  publisher    = {{American College of Medical Physics}},
  series       = {{Journal of Applied Clinical Medical Physics}},
  title        = {{A semi-automated workflow for cohort-wise preparation of radiotherapy data for dose-response modeling, including autosegmentation of organs at risk}},
  url          = {{http://dx.doi.org/10.1002/acm2.70152}},
  doi          = {{10.1002/acm2.70152}},
  volume       = {{26}},
  year         = {{2025}},
}