Daily Papers

Contouring is an indispensable step in Radiotherapy (RT) treatment planning. However, today's contouring software is constrained to only work with a 2D display, which is less intuitive and requires high task loads. Virtual Reality (VR) has shown great potential in various specialties of healthcare and health sciences education due to the unique advantages of intuitive and natural interactions in immersive spaces. VR-based radiation oncology integration has also been advocated as a target healthcare application, allowing providers to directly interact with 3D medical structures. We present VRContour and investigate how to effectively bring contouring for radiation oncology into VR. Through an autobiographical iterative design, we defined three design spaces focused on contouring in VR with the support of a tracked tablet and VR stylus, and investigating dimensionality for information consumption and input (either 2D or 2D + 3D). Through a within-subject study (n = 8), we found that visualizations of 3D medical structures significantly increase precision, and reduce mental load, frustration, as well as overall contouring effort. Participants also agreed with the benefits of using such metaphors for learning purposes.

This work considers gradient-based mesh optimization, where we iteratively optimize for a 3D surface mesh by representing it as the isosurface of a scalar field, an increasingly common paradigm in applications including photogrammetry, generative modeling, and inverse physics. Existing implementations adapt classic isosurface extraction algorithms like Marching Cubes or Dual Contouring; these techniques were designed to extract meshes from fixed, known fields, and in the optimization setting they lack the degrees of freedom to represent high-quality feature-preserving meshes, or suffer from numerical instabilities. We introduce FlexiCubes, an isosurface representation specifically designed for optimizing an unknown mesh with respect to geometric, visual, or even physical objectives. Our main insight is to introduce additional carefully-chosen parameters into the representation, which allow local flexible adjustments to the extracted mesh geometry and connectivity. These parameters are updated along with the underlying scalar field via automatic differentiation when optimizing for a downstream task. We base our extraction scheme on Dual Marching Cubes for improved topological properties, and present extensions to optionally generate tetrahedral and hierarchically-adaptive meshes. Extensive experiments validate FlexiCubes on both synthetic benchmarks and real-world applications, showing that it offers significant improvements in mesh quality and geometric fidelity.

Radiotherapy (RT) planning is complex, subjective, and time-intensive. Advances in artificial intelligence (AI) promise to improve its precision, efficiency, and consistency, but progress is often limited by the scarcity of large, standardized datasets. To address this, we introduce the Automated Iterative RT Planning (AIRTP) system, a scalable solution for generating high-quality treatment plans. This scalable solution is designed to generate substantial volumes of consistently high-quality treatment plans, overcoming a key obstacle in the advancement of AI-driven RT planning. Our AIRTP pipeline adheres to clinical guidelines and automates essential steps, including organ-at-risk (OAR) contouring, helper structure creation, beam setup, optimization, and plan quality improvement, using AI integrated with RT planning software like Eclipse of Varian. Furthermore, a novel approach for determining optimization parameters to reproduce 3D dose distributions, i.e. a method to convert dose predictions to deliverable treatment plans constrained by machine limitations. A comparative analysis of plan quality reveals that our automated pipeline produces treatment plans of quality comparable to those generated manually, which traditionally require several hours of labor per plan. Committed to public research, the first data release of our AIRTP pipeline includes nine cohorts covering head-and-neck and lung cancer sites to support an AAPM 2025 challenge. This data set features more than 10 times the number of plans compared to the largest existing well-curated public data set to our best knowledge. Repo:{https://github.com/RiqiangGao/GDP-HMM_AAPMChallenge}

Most papers caution against using predictive models for disease stratification based on unselected radiomic features, as these features are affected by contouring variability. Instead, they advocate for the use of the Intraclass Correlation Coefficient (ICC) as a measure of stability for feature selection. However, the direct effect of segmentation variability on the predictive models is rarely studied. This study investigates the impact of segmentation variability on feature stability and predictive performance in radiomics-based prediction of Triple-Negative Breast Cancer (TNBC) subtype using Magnetic Resonance Imaging. A total of 244 images from the Duke dataset were used, with segmentation variability introduced through modifications of manual segmentations. For each mask, explainable radiomic features were selected using the Shapley Additive exPlanations method and used to train logistic regression models. Feature stability across segmentations was assessed via ICC, Pearson's correlation, and reliability scores quantifying the relationship between feature stability and segmentation variability. Results indicate that segmentation accuracy does not significantly impact predictive performance. While incorporating peritumoral information may reduce feature reproducibility, it does not diminish feature predictive capability. Moreover, feature selection in predictive models is not inherently tied to feature stability with respect to segmentation, suggesting that an overreliance on ICC or reliability scores for feature selection might exclude valuable predictive features.