{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T05:48:26Z","timestamp":1775627306503,"version":"3.50.1"},"reference-count":33,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,4,27]],"date-time":"2020-04-27T00:00:00Z","timestamp":1587945600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Physics"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>Accurate identification of the prostatic urethra and bladder can help determine dosing and evaluate urinary toxicity during intensity\u2010modulated radiation therapy (IMRT) planning in patients with localized prostate cancer. However, it is challenging to locate the prostatic urethra in planning computed tomography (pCT). In the present study, we developed a multiatlas\u2013based auto\u2010segmentation method for prostatic urethra identification using deformable image registration accuracy prediction with machine learning (ML) and assessed its feasibility.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We examined 120 patients with prostate cancer treated with IMRT. All patients underwent temporary urinary catheter placement for identification and contouring of the prostatic urethra in pCT images (ground truth). Our method comprises the following three steps: (a) select four atlas datasets from the atlas datasets using the deformable image registration (DIR) accuracy prediction model, (b) deform them by structure\u2010based DIR, (3) and propagate urethra contour using displacement vector field calculated by the DIR. In (a), for identifying suitable datasets, we used the trained support vector machine regression (SVR) model and five feature descriptors (e.g., prostate volume) to increase DIR accuracy. This method was trained\/validated using 100 patients and performance was evaluated within an independent test set of 20 patients. Fivefold cross\u2010validation was used to optimize the hype parameters of the DIR accuracy prediction model. We assessed the accuracy of our method by comparing it with those of two others: Acostas method\u2010based patient selection (previous study method, by Acosta et al.), and the Waterman\u2019s method (defines the prostatic urethra based on the center of the prostate, by Waterman et al.). We used the centerlines distance (CLD) between the ground truth and the predicted prostatic urethra as the evaluation index.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The CLD in the entire prostatic urethra was 2.09\u00a0\u00b1\u00a00.89\u00a0mm (our proposed method), 2.77\u00a0\u00b1\u00a00.99\u00a0mm (Acosta et al., <jats:italic>P<\/jats:italic>\u00a0=\u00a00.022), and 3.47\u00a0\u00b1\u00a01.19\u00a0mm (Waterman et al., <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001); our proposed method showed the highest accuracy. In segmented CLD, CLD in the top 1\/3 segment was highly improved from that of Waterman et.al. and was slightly improved from that of Acosta et.al., with results of 2.49\u00a0\u00b1\u00a01.78\u00a0mm (our proposed method), 2.95\u00a0\u00b1\u00a01.75\u00a0mm (Acosta et al., <jats:italic>P<\/jats:italic>\u00a0=\u00a00.42), and 5.76\u00a0\u00b1\u00a03.09\u00a0mm (Waterman et al., <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We developed a DIR accuracy prediction model\u2013based multiatlas\u2013based auto\u2010segmentation method for prostatic urethra identification. Our method identified prostatic urethra with mean error of 2.09\u00a0mm, likely due to combined effects of SVR model employment in patient selection, modified atlas dataset characteristics and DIR algorithm. Our method has potential utility in prostate cancer IMRT and can replace use of temporary indwelling urinary catheters.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mp.14154","type":"journal-article","created":{"date-parts":[[2020,3,23]],"date-time":"2020-03-23T06:01:12Z","timestamp":1584943272000},"page":"3023-3031","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Multi\u2010atlas\u2013based auto\u2010segmentation for prostatic urethra using novel prediction of deformable image registration accuracy"],"prefix":"10.1002","volume":"47","author":[{"given":"Hisamichi","family":"Takagi","sequence":"first","affiliation":[{"name":"Course of Radiological Technology Health Sciences Tohoku University Graduate School of Medicine Sendai Miyagi 980\u20108575 Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noriyuki","family":"Kadoya","sequence":"additional","affiliation":[{"name":"Department of Radiation 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