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The influence of initial outlines on manual segmentation
Author(s) -
Sensakovic William F.,
Starkey Adam,
Roberts Rachael,
Straus Christopher,
Caligiuri Philip,
Kocherginsky Masha,
Armato Samuel G.
Publication year - 2010
Publication title -
medical physics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.473
H-Index - 180
eISSN - 2473-4209
pISSN - 0094-2405
DOI - 10.1118/1.3392287
Subject(s) - observer (physics) , segmentation , jaccard index , nuclear medicine , mathematics , computer science , artificial intelligence , medicine , pattern recognition (psychology) , physics , quantum mechanics
Purpose: Initial outlines are often presented as an aid to reduce the time‐cost associated with manual segmentation and measurement of structures in medical images. This study evaluated the influence of initial outlines on manual segmentation intraobserver and interobserver precision. Methods: Three observers independently outlined all pleural mesothelioma tumors present in five computed tomography (CT) sections in each of 30 patient scans. After a lapse of time, each observer was presented with the same series of CT sections with the outlines of each observer superimposed as initial outlines. Each observer created altered outlines by altering the initial outlines to reflect their perception of the tumor boundary. Altered outlines were compared to original outlines using the Jaccard similarity coefficient ( J ) . Intraobserver and interobserver precision of observer outlines were calculated by applying linear mixed effects analysis of variance models to the J values. The percent of minor alterations (alterations that resulted in only slight changes in the initial outline) was also recorded. Results: The average J value between pairs of observer original outlines was 0.371. The average J value between pairs of observer outlines when altered from an identical initial outline was 0.796, indicating increased interobserver precision. The average difference between J values of an observer's segmentation created by altering their own initial outline and when altering a different observer's initial outline was 0.476, indicating initial outlines strongly influence intraobserver precision. Observers made minor alterations on 74.5% of initial outlines with which they were presented. Conclusions: Intraobserver and interobserver precision were strongly dependent on the initial outline. These effects are likely due to the tendency of observers to make only minor corrections to initial outlines. This finding could impact observer study design, tumor growth assessment, computer‐aided diagnosis system validation, and radiation therapy target volume definition when initial outlines are used as an observer aid.