Lung tumor boundary tracking in MRI with moving mesh correspondences for adaptive radio therapy

Delineation of lung tumor regions from magnetic resonance imaging (MRI) poses many difficulties due to MR signal similarities of the region of interest and surrounding area as well as the influence of respiration. However, accurate segmentation of the tumor region is of utmost importance in planning a radiation therapy since a small error can result in some healthy tissues to receive excessive radiation. This study presents a semi-automated method to delineate lung tumor regions from a sequence of MRIs. The proposed method uses a non-rigid image registration framework to propagate the boundaries of the tumor region in MRI acquired during a radiation treatment stage, given manual segmentation on frames acquired during pretreatment stage. We investigate two approaches: 1) the first one utilizes manual segmentation of the first frame during the pretreatment stage; and 2) the second one utilizes manual segmentation of all the frames during the pretreatment stage. We evaluated the proposed approaches over a sequence of 400 images acquired from 4 patients. The proposed method based on the utilization of all the frames yielded a Dice score of 0.90 ± 0.04 and a Hausdorff distance of 1.17 ± 0.35 pixels (2.83 ± 0.79 mm) in comparison to expert manual segmentation.