Fully automated target delineation service in multi-institutional environment in Finland (FAST)

Project lead: Jan Seppälä, Chief Physicist (KUH)

According to many publications, there are remarkable variations in radiotherapy (RT) target delineation. The interobserver variability in target delineation is the biggest source of uncertainty in RT process, potentially inducing systematic errors in radiation dose delivery. In some cases, this uncertainty can have a huge impact on the clinical outcome of individual patients. Different tools to reduce the variability in target volume delineation has been studied, such as training, guidelines, and autosegmentation methods. In this clinical research study, we will implement fully automated target delineation service into multi-institutional environment, which should decrease the interobserver variability.

The developed delineation service consists of the following components: pseudononymization gateway in a hospital network, Ensemble integration platform between the hospital and delineation service, and autosegmentation server.

Fully automated delineation process has the following steps:

  1. CT-scanner exports CT slices to pseudonymization gateway on which Conquest service is configured to pseudonymize these CT slices and export them to Ensemble integration platform.
  2. Ensemble integration platform uses SFTP protocol to transfer CT-slices to autosegmentation server.
  3. On the server, an autosegmentation service will automatically start the segmentation for all new data it receives. This atlas-based autosegmentation consists multiple atlases, which are contoured carefully according to the European guidelines.
  4. After the segmentation is completed, Ensemble integration platform will forward delineated structures to the hospital network where Conquest service removes pseudonymization and forwards the delineated structures to TPS.

The project will utilize state of the art autosegmentation software and research topics will focus on the accuracy of the autosegmentation and the clinical significance of it.

The project consortium consists of all 12 public Finnish radiotherapy centers located in Helsinki, Joensuu, Jyväskylä, Kotka, Lahti, Lappeenranta, Oulu, Pori, Tampere, Turku and Vaasa.

The project was initially started with the help of FICAN (Comprehensive Cancer Center Finland) and FICAN-East.