{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T06:09:06Z","timestamp":1790316546249,"version":"4.1.0"},"reference-count":32,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2022,7,25]],"date-time":"2022-07-25T00:00:00Z","timestamp":1658707200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: Organs at risk (OARs) delineation is a crucial step of radiotherapy (RT) treatment planning workflow. Time-consuming and inter-observer variability are main issues in manual OAR delineation, mainly in the head and neck (H &amp; N) district. Deep-learning based auto-segmentation is a promising strategy to improve OARs contouring in radiotherapy departments. A comparison of deep-learning-generated auto-contours (AC) with manual contours (MC) was performed by three expert radiation oncologists from a single center. Methods: Planning computed tomography (CT) scans of patients undergoing RT treatments for H&amp;N cancers were considered. CT scans were processed by Limbus Contour auto-segmentation software, a commercial deep-learning auto-segmentation based software to generate AC. H&amp;N protocol was used to perform AC, with the structure set consisting of bilateral brachial plexus, brain, brainstem, bilateral cochlea, pharyngeal constrictors, eye globes, bilateral lens, mandible, optic chiasm, bilateral optic nerves, oral cavity, bilateral parotids, spinal cord, bilateral submandibular glands, lips and thyroid. Manual revision of OARs was performed according to international consensus guidelines. The AC and MC were compared using the Dice similarity coefficient (DSC) and 95% Hausdorff distance transform (DT). Results: A total of 274 contours obtained by processing CT scans were included in the analysis. The highest values of DSC were obtained for the brain (DSC 1.00), left and right eye globes and the mandible (DSC 0.98). The structures with greater MC editing were optic chiasm, optic nerves and cochleae. Conclusions: In this preliminary analysis, deep-learning auto-segmentation seems to provide acceptable H&amp;N OAR delineations. For less accurate organs, AC could be considered a starting point for review and manual adjustment. Our results suggest that AC could become a useful time-saving tool to optimize workload and resources in RT departments.<\/jats:p>","DOI":"10.3390\/ijerph19159057","type":"journal-article","created":{"date-parts":[[2022,7,25]],"date-time":"2022-07-25T21:20:59Z","timestamp":1658784059000},"page":"9057","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Clinical Validation of a Deep-Learning Segmentation Software in Head and Neck: An Early Analysis in a Developing Radiation Oncology Center"],"prefix":"10.3390","volume":"19","author":[{"given":"Andrea","family":"D\u2019Aviero","sequence":"first","affiliation":[{"name":"Radiation Oncology, Mater Olbia Hospital, 07026 Olbia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessia","family":"Re","sequence":"additional","affiliation":[{"name":"Radiation Oncology, Mater Olbia Hospital, 07026 Olbia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2619-4918","authenticated-orcid":false,"given":"Francesco","family":"Catucci","sequence":"additional","affiliation":[{"name":"Radiation Oncology, Mater Olbia Hospital, 07026 Olbia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danila","family":"Piccari","sequence":"additional","affiliation":[{"name":"Radiation Oncology, Mater Olbia Hospital, 07026 Olbia, Italy"},{"name":"UOC Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Votta","sequence":"additional","affiliation":[{"name":"Radiation Oncology, Mater Olbia Hospital, 07026 Olbia, Italy"},{"name":"UOC Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico","family":"Piro","sequence":"additional","affiliation":[{"name":"Radiation Oncology, Mater Olbia Hospital, 07026 Olbia, Italy"},{"name":"UOC Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Piras","sequence":"additional","affiliation":[{"name":"UO Radioterapia Oncologica, Villa Santa Teresa, 90011 Bagheria, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmela","family":"Di Dio","sequence":"additional","affiliation":[{"name":"Radiation Oncology, Mater Olbia Hospital, 07026 Olbia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Iezzi","sequence":"additional","affiliation":[{"name":"Radiation Oncology, Mater Olbia Hospital, 07026 Olbia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6780-6621","authenticated-orcid":false,"given":"Francesco","family":"Preziosi","sequence":"additional","affiliation":[{"name":"Radiation Oncology, Mater Olbia Hospital, 07026 Olbia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0556-3593","authenticated-orcid":false,"given":"Sebastiano","family":"Menna","sequence":"additional","affiliation":[{"name":"Medical Physics, Mater Olbia Hospital, 07026 Sassari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flaviovincenzo","family":"Quaranta","sequence":"additional","affiliation":[{"name":"Medical Physics, Mater Olbia Hospital, 07026 Sassari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Althea","family":"Boschetti","sequence":"additional","affiliation":[{"name":"Radiation Oncology, Mater Olbia Hospital, 07026 Olbia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Marras","sequence":"additional","affiliation":[{"name":"Radiation Oncology, Mater Olbia Hospital, 07026 Olbia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Miccich\u00e8","sequence":"additional","affiliation":[{"name":"UOC Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3343-2806","authenticated-orcid":false,"given":"Roberto","family":"Gallus","sequence":"additional","affiliation":[{"name":"Otolaryngology, Mater Olbia Hospital, 07026 Sassari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8073-9005","authenticated-orcid":false,"given":"Luca","family":"Indovina","sequence":"additional","affiliation":[{"name":"UOC Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6261-2772","authenticated-orcid":false,"given":"Francesco","family":"Bussu","sequence":"additional","affiliation":[{"name":"Otolaryngology, Azienda Ospedaliero Universitaria di Sassari, 07100 Sassari, Italy"},{"name":"Dipartimento delle Scienze Mediche, Chirurgiche e Sperimentali, Universit\u00e0 di Sassari, 07100 Sassari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Valentini","sequence":"additional","affiliation":[{"name":"UOC Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Roma, Italy"},{"name":"Dipartimento di Scienze Radiologiche ed Ematologiche, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Cusumano","sequence":"additional","affiliation":[{"name":"Medical Physics, Mater Olbia Hospital, 07026 Sassari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gian Carlo","family":"Mattiucci","sequence":"additional","affiliation":[{"name":"Radiation Oncology, Mater Olbia Hospital, 07026 Olbia, Italy"},{"name":"Dipartimento di Scienze Radiologiche ed Ematologiche, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,25]]},"reference":[{"key":"ref_1","unstructured":"AIOM (2022, March 24). 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