Delineating critical structures for radiotherapy of the brain is required for advanced radiotherapy technologies to
determine if the dose from the proposed treatment will impair the functionality of the structures. Employing an
automatic segmentation computer module in the radiation oncology treatment planning process has the potential to
significantly increase the efficiency, cost-effectiveness, and, ultimately, clinical outcome of patients undergoing
radiation therapy. In earlier work, we have shown that atlas-based segmentation of large structures such as the brainstem
or the cerebellum was an achievable objective. We have also shown that smaller structures such as the optic nerves or
optic chiasm were more difficult to segment automatically. In this work, we present an extension to this approach in
which atlas-based segmentation is followed by a series of additional steps. We show that this new approach substantially
improves our previous results. We also show that we can segment CT images alone when we previously relied on a
combination of MR and CT images.
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