Imaging of cervical cancer

Simultaneous nonrigid registration, segmentation, and tumor detection in MRI guided cervical cancer radiation therapy

External beam radiation therapy (EBRT) for the treatment of cancer enables accurate placement of radiation dose on the cancerous region. However, the deformation of soft tissue during the course of treatment, such as in cervical cancer, presents significant challenges for the delineation of the target volume and other structures of interest. Furthermore, the presence and regression of pathologies such as tumors may violate registration constraints and cause registration errors. In this paper, automatic segmentation, nonrigid registration and tumor detection in cervical magnetic resonance (MR) data are addressed simultaneously using a unified Bayesian framework. The proposed novel method can generate a tumor probability map while progressively identifying the boundary of an organ of interest based on the achieved nonrigid transformation. The method is able to handle the challenges of significant tumor regression and its effect on surrounding tissues. The new method was compared to various currently existing algorithms on a set of 36 MR data from six patients, each patient has six T2-weighted MR cervical images. The results show that the proposed approach achieves an accuracy comparable to manual segmentation and it significantly outperforms the existing registration algorithms. In addition, the tumor detection result generated by the proposed method has a high agreement with manual delineation by a qualified clinician.

Registration of cervical MRI using multifeature mutual information

Radiation therapy for cervical cancer can benefit from image registration in several ways, for example by studying the motion of organs, or by (partially) automating the delineation of the target volume and other structures of interest. In this paper, the registration of cervical data is addressed using mutual information (MI) of not only image intensity, but also features that describe local image structure. Three aspects of the registration are addressed to make this approach feasible. First, instead of relying on a histogram-based estimation of mutual information, which poses problems for a larger number of features, a graph-based implementation of alpha-mutual information (alpha-MI) is employed. Second, the analytical derivative of alpha-MI is derived. This makes it possible to use a stochastic gradient descent method to solve the registration problem, which is substantially faster than nonderivative-based methods. Third, the feature space is reduced by means of a principal component analysis, which also decreases the registration time. The proposed technique is compared to a standard approach, based on the mutual information of image intensity only. Experiments are performed on 93 T2-weighted MR clinical data sets acquired from 19 patients with cervical cancer. Several characteristics of the proposed algorithm are studied on a subset of 19 image pairs (one pair per patient). On the remaining data (36 image pairs, one or two pairs per patient) the median overlap is shown to improve significantly compared to standard MI from 0.85 to 0.86 for the clinical target volume (CTV, p = 2 x 10(-2)), from 0.75 to 0.81 for the bladder (p = 8 x 10(-6)), and from 0.76 to 0.77 for the rectum (p = 2 x 10(-4)). The registration error is improved at important tissue interfaces, such as that of the bladder with the CTV, and the interface of the rectum with the uterus and cervix.