Gamma Knife treatment planning: MR brain tumor segmentation and volume measurement based on unsupervised Fuzzy C-Means clustering

Nowadays, radiation treatment is beginning to intensively use MRI thanks to its greater ability to discriminate healthy and diseased soft-tissues. Leksell Gamma Knife® is a radio-surgical device, used to treat different brain lesions, which are often inaccessible for conventional surgery, such as benign or malignant tumors. Currently, the target to be treated with radiation therapy is contoured with slice-by-slice manual segmentation on MR datasets. This approach makes the segmentation procedure time consuming and operator-dependent. The repeatability of the tumor boundary delineation may be ensured only by using automatic or semiautomatic methods, supporting clinicians in the treatment planning phase. This article proposes a semiautomatic segmentation method, based on the unsupervised Fuzzy C-Means clustering algorithm. Our approach helps segment the target and automatically calculates the lesion volume. To evaluate the performance of the proposed approach, segmentation tests on 15 MR datasets were performed, using both area-based and distance-based metrics, obtaining the following average values: Similarity Index=95.59%, Jaccard Index=91.86%, Sensitivity=97.39%, Specificity=94.30%, Mean Absolute Distance=0.246[pixels], Maximum Distance=1.050[pixels], and Hausdorff Distance=1.365[pixels].