Automatic Segmentation of Tissues in CT Images of the Pelvic Region

In brachytherapy, radiation therapy is performed by placing the radiation source into or very close to the tumour. When calculating the absorbed dose, water is often used as the radiation transport and dose scoring medium for soft tissues and this leads to inaccuracies. The iterative reconstruction algorithm DIRA is under development at the Center for Medical Imaging Science and Visualization, Linköping University. DIRA uses dual-energy CT to decompose tissues into different doublets and triplets of base components for a better absorbed dose estimation. To accurately determine mass fractions of these base components for different tissues, the tissues needs to be identified in the image. The aims of this master thesis are: (i) Find an automated segmentation algorithm in CT that best segments the male pelvis. (ii) Implement a segmentation algorithm that can be used in DIRA. (iii) Implement a fully automatic segmentation algorithm. Seven segmentation methods were tested in Matlab using images obtained from Linköping University Hospital. The methods were: active contours, atlas based registration, graph cuts, level set, region growing, thresholding and watershed. Four segmentation algorithms were selected for further analysis: phase based atlas registration, region growing, thresholding and active contours without edges. The four algorithms were combined and supplemented with other image analysis methods to form a fully automated segmentation algorithm that was implemented in DIRA. The newly developed algorithm (named MK2014) was sufficiently stable for pelvic image segmentation with a mean computational time of 45.3 s and a mean Dice similarity coefficient of 0.925 per 512×512 image. The performance of MK2014 tested on a simplified anthropomorphic phantom in DIRA gave promising result. Additional tests with more realistic phantoms are needed to confirm the general applicability of MK2014 in DIRA