{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T13:44:22Z","timestamp":1768311862226,"version":"3.49.0"},"reference-count":47,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2023,9,18]],"date-time":"2023-09-18T00:00:00Z","timestamp":1694995200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Department of Engineering, Universit\u00e0 degli Studi di Perugia","award":["D.D. 132\/2022"],"award-info":[{"award-number":["D.D. 132\/2022"]}]},{"name":"Department of Engineering, Universit\u00e0 degli Studi di Perugia","award":["D.M. 351\/2022"],"award-info":[{"award-number":["D.M. 351\/2022"]}]},{"name":"Italian Ministry of University and Research (MUR)","award":["D.D. 132\/2022"],"award-info":[{"award-number":["D.D. 132\/2022"]}]},{"name":"Italian Ministry of University and Research (MUR)","award":["D.M. 351\/2022"],"award-info":[{"award-number":["D.M. 351\/2022"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Background. Head and neck cancer (HNC) is the seventh most common neoplastic disorder at the global level. Contouring HNC lesions on [18F] Fluorodeoxyglucose positron emission tomography\/computed tomography (FDG PET\/CT) scans plays a fundamental role for diagnosis, risk assessment, radiotherapy planning and post-treatment evaluation. However, manual contouring is a lengthy and tedious procedure which requires significant effort from the clinician. Methods. We evaluated the performance of six hand-crafted, training-free methods (four threshold-based, two algorithm-based) for the semi-automated delineation of HNC lesions on FDG PET\/CT. This study was carried out on a single-centre population of\u00a0n=103\u00a0subjects, and the standard of reference was manual segmentation generated by nuclear medicine specialists. Figures of merit were the S\u00f8rensen\u2013Dice coefficient (DSC) and relative volume difference (RVD). Results. Median DSC ranged between 0.595 and 0.792, median\u00a0RVD\u00a0between \u221222.0% and 87.4%. Click and draw and Nestle\u2019s methods achieved the best segmentation accuracy (median DSC, respectively, 0.792 \u00b1 0.178 and 0.762 \u00b1 0.107; median RVD, respectively, \u221221.6% \u00b1 1270.8% and \u221232.7% \u00b1 40.0%) and outperformed the other methods by a significant margin. Nestle\u2019s method also resulted in a lower dispersion of the data, hence showing stronger inter-patient stability. The accuracy of the two best methods was in agreement with the most recent state-of-the art results. Conclusions. Semi-automated PET delineation methods show potential to assist clinicians in the segmentation of HNC lesions on FDG PET\/CT images, although manual refinement may sometimes be needed to obtain clinically acceptable ROIs.<\/jats:p>","DOI":"10.3390\/s23187952","type":"journal-article","created":{"date-parts":[[2023,9,18]],"date-time":"2023-09-18T05:59:06Z","timestamp":1695016746000},"page":"7952","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Performance Analysis of Six Semi-Automated Tumour Delineation Methods on [18F] Fluorodeoxyglucose Positron Emission Tomography\/Computed Tomography (FDG PET\/CT) in Patients with Head and Neck Cancer"],"prefix":"10.3390","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3371-1928","authenticated-orcid":false,"given":"Francesco","family":"Bianconi","sequence":"first","affiliation":[{"name":"Department of Engineering, Universit\u00e0 degli Studi di Perugia, Via Goffredo Duranti 93, 06125 Perugia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Salis","sequence":"additional","affiliation":[{"name":"Unit of Nuclear Medicine, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3104-8782","authenticated-orcid":false,"given":"Mario Luca","family":"Fravolini","sequence":"additional","affiliation":[{"name":"Department of Engineering, Universit\u00e0 degli Studi di Perugia, Via Goffredo Duranti 93, 06125 Perugia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad Usama","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Engineering, Universit\u00e0 degli Studi di Perugia, Via Goffredo Duranti 93, 06125 Perugia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matteo","family":"Minestrini","sequence":"additional","affiliation":[{"name":"Section of Nuclear Medicine and Health Physics, Department of Medicine and Surgery, Universit\u00e0 degli Studi di Perugia, Piazza Lucio Severi 1, 06132 Perugia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4423-5496","authenticated-orcid":false,"given":"Luca","family":"Filippi","sequence":"additional","affiliation":[{"name":"Policlinico Tor Vergata Hospital, Viale Oxford 81, 00133 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7038-3615","authenticated-orcid":false,"given":"Andrea","family":"Marongiu","sequence":"additional","affiliation":[{"name":"Unit of Nuclear Medicine, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7194-985X","authenticated-orcid":false,"given":"Susanna","family":"Nuvoli","sequence":"additional","affiliation":[{"name":"Unit of Nuclear Medicine, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5753-399X","authenticated-orcid":false,"given":"Angela","family":"Spanu","sequence":"additional","affiliation":[{"name":"Unit of Nuclear Medicine, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2475-343X","authenticated-orcid":false,"given":"Barbara","family":"Palumbo","sequence":"additional","affiliation":[{"name":"Section of Nuclear Medicine and Health Physics, Department of Medicine and Surgery, Universit\u00e0 degli Studi di Perugia, Piazza Lucio Severi 1, 06132 Perugia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"780","DOI":"10.1038\/s41415-022-5166-x","article-title":"Reviewing the epidemiology of head and neck cancer: Definitions, trends and risk factors","volume":"233","author":"Gormley","year":"2022","journal-title":"Br. 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