Precise ablation zone segmentation on CT images after liver cancer ablation using semi‐automatic CNN‐based segmentation.

Background Purpose Methods Results Conclusions Ablation zone segmentation in contrast‐enhanced computed tomography (CECT) images enables the quantitative assessment of treatment success in the ablation of liver lesions. However, fully automatic liver ablation zone segmentation in CT images still remains challenging, such as low accuracy and time‐consuming manual refinement of the incorrect regions.Therefore, in this study, we developed a semi‐automatic technique to address the remaining drawbacks and improve the accuracy of the liver ablation zone segmentation in the CT images.Our approach uses a combination of a CNN‐based automatic segmentation method and an interactive CNN‐based segmentation method. First, automatic segmentation is applied for coarse ablation zone segmentation in the whole CT image. Human experts then visually validate the segmentation results. If there are errors in the coarse segmentation, local corrections can be performed on each slice via an interactive CNN‐based segmentation method. The models were trained and the proposed method was evaluated using two internal datasets of post‐interventional CECT images (n1$n_{1}$ = 22, n2$n_{2}$ = 145; 62 patients in total) and then further tested using an external benchmark dataset (n3$n_{3}$ = 12; 10 patients).To evaluate the accuracy of the proposed approach, we used Dice similarity coefficient (<italic>DSC</italic>), average symmetric surface distance (<italic>ASSD</italic>), Hausdorff distance (<italic>HD</italic>), and volume difference (<italic>VD</italic>). The quantitative evaluation results show that the proposed approach obtained mean <italic>DSC</italic>, <italic>ASSD</italic>, <italic>HD</italic>, and <italic>VD</italic> scores of 94.0%, 0.4 mm, 8.4 mm, 0.02, respectively, on the internal dataset, and 87.8%, 0.9 mm, 9.5 mm, and −0.03, respectively, on the benchmark dataset. We also compared the performance of the proposed approach to that of five well‐known segmentation methods; the proposed semi‐automatic method achieved state‐of‐the‐art performance on ablation segmentation accuracy, and on average, 2 min are required to correct the segmentation. Furthermore, we found that the accuracy of the proposed method on the benchmark dataset is comparable to that of manual segmentation by human experts (p$p$ = 0.55, t$t$‐test).The proposed semi‐automatic CNN‐based segmentation method can be used to effectively segment the ablation zones, increasing the value of CECT for an assessment of treatment success. For reproducibility, the trained models, source code, and demonstration tool are publicly available at https://github.com/lqanh11/Interactive_AblationZone_Segmentation. [ABSTRACT FROM AUTHOR]