TriSwinUNETR Lobe Segmentation Model for Computing DIR-Free CT-Ventilation

Authors

Gabriela Roque Oliveira Nomura
Aarom T. Luong
Ananya Prakash
Annabelle Alemand
Tanish Bhowmick
Alisa Ali
Jaimie Ren
Basil Rehani
Girish Nair
Richard Castillo
Yevgeniy Vinogradskiy, Thomas Jefferson UniversityFollow
Edward Castillo

Document Type

Article

Publication Date

2-17-2025

Comments

This article is the author's final published version in Frontiers in Oncology, Volume 15, 2025, Article number 1475133.

The published version is available at https://doi.org/10.3389/fonc.2025.1475133.

Copyright © 2025 Nomura, Luong, Prakash, Alemand, Bhowmick, Ali, Ren, Rehani, Nair, Castillo, Vinogradskiy and Castillo

Abstract

Purpose: Functional radiotherapy avoids the delivery of high-radiation dosages to high-ventilated lung areas. Methods to determine CT-ventilation imaging (CTVI) typically rely on deformable image registration (DIR) to calculate volume changes within inhale/exhale CT image pairs. Since DIR is a non-trivial task that can bias CTVI, we hypothesize that lung volume changes needed to calculate CTVI can be computed from AI-driven lobe segmentations in inhale/exhale phases, without DIR. We utilize a novel lobe segmentation pipeline (TriSwinUNETR), and the resulting inhale/exhale lobe volumes are used to calculate CTVI. Methods: Our pipeline involves three SwinUNETR networks, each trained on 6,501 CT image pairs from the COPDGene study. An initial network provides right/left lung segmentations used to define bounding boxes for each lung. Bounding boxes are resized to focus on lung volumes and then lobes are segmented with dedicated right and left SwinUNETR networks. Fine-tuning was conducted on CTs from 11 patients treated with radiotherapy for non-small cell lung cancer. Five-fold cross-validation was then performed on 51 LUNA16 cases with manually delineated ground truth. Breathing-induced volume change was calculated for each lobe using AI-defined lobe volumes from inhale/exhale phases, without DIR. Resulting lobar CTVI values were validated with 4DCT and positron emission tomography (PET)-Galligas ventilation imaging for 19 lung cancer patients. Spatial Spearman correlation between TriSwinUNETR lobe ventilation and ground-truth PET-Galligas ventilation was calculated for each patient. Results: TriSwinUNETR achieved a state-of-the-art mean Dice score of 93.72% (RUL: 93.49%, RML: 85.78%, RLL: 95.65%, LUL: 97.12%, LLL: 96.58%), outperforming best-reported accuracy of 92.81% for the lobe segmentation task. CTVI calculations yielded a median Spearman correlation coefficient of 0.9 across 19 cases, with 13 cases exhibiting correlations of at least 0.5, indicating strong agreement with PET-Galligas ventilation. Conclusion: Our TriSwinUNETR pipeline demonstrated superior performance in the lobe segmentation task, while our segmentation-based CTVI exhibited strong agreement with PET-Galligas ventilation. Moreover, as our approach leverages deep-learning for segmentation, it provides interpretable ventilation results and facilitates quality assurance, thereby reducing reliance on DIR.

Recommended Citation

Nomura, Gabriela Roque Oliveira; Luong, Aarom T.; Prakash, Ananya; Alemand, Annabelle; Bhowmick, Tanish; Ali, Alisa; Ren, Jaimie; Rehani, Basil; Nair, Girish; Castillo, Richard; Vinogradskiy, Yevgeniy; and Castillo, Edward, "TriSwinUNETR Lobe Segmentation Model for Computing DIR-Free CT-Ventilation" (2025). Department of Radiation Oncology Faculty Papers. Paper 203.
https://jdc.jefferson.edu/radoncfp/203

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 License.

Language

English