The larynx, or the voice-box, is a common site of occurrence of Head and Neck cancers. Yet, automated segmentation of the larynx has been receiving very little attention. Segmentation of organs is an essential step in cancer treatment-planning. Computed Tomography scans are routinely used to assess the extent of tumor spread in the Head and Neck as they are fast to acquire and tolerant to some movement.This paper reviews various automated detection and segmentation methods used for the larynx on Computed Tomography images. Image registration and deep learning approaches to segmenting the laryngeal anatomy are compared, highlighting their strengths and shortcomings. A list of available annotated laryngeal computed tomography datasets is compiled for encouraging further research. Commercial software currently available for larynx contouring are briefed in our work.We conclude that the lack of standardisation on larynx boundaries and the complexity of the relatively small structure makes automated segmentation of the larynx on computed tomography images a challenge. Reliable computer aided intervention in the contouring and segmentation process will help clinicians easily verify their findings and look for oversight in diagnosis. This review is useful for research that works with artificial intelligence in Head and Neck cancer, specifically that deals with the segmentation of laryngeal anatomy.
The larynx, a common site for head and neck cancers, is often overlooked in automated contouring due to its small size and anatomically complex nature. More than 75% of laryngeal tumors originate in the glottis. This paper proposes a method to automatically delineate the glottic tumors present contrast computed tomography (CT) images of the head and neck. A novel dataset of 340 images with glottic tumors was acquired and pre-processed, and a senior radiologist created a detailed, manual slice-by-slice tumor annotation. An efficient deep-learning architecture, the U-Net, was modified and trained on our novel dataset to segment the glottic tumor automatically. The tumor was then visualized with the corresponding ground truth. Using a combined metric of dice score and binary cross-entropy, we obtained an overlap of 86.68% for the train set and 82.67% for the test set. The results are comparable to the limited work done in this area. This paper’s novelty lies in the compiled dataset and impressive results obtained with the size of the data. Limited research has been done on the automated detection and diagnosis of laryngeal cancers. Automating the segmentation process while ensuring malignancies are not overlooked is essential to saving the clinician’s time.
Accurate classification of laryngeal cancer is a critical step for diagnosis and appropriate treatment. Radiomics is a rapidly advancing field in medical image processing that uses various algorithms to extract many quantitative features from radiological images. The high dimensional features extracted tend to cause overfitting and increase the complexity of the classification model. Thereby, feature selection plays an integral part in selecting relevant features for the classification problem. In this study, we explore the predictive capabilities of radiomics on Computed Tomography (CT) images with the incidence of laryngeal cancer to predict the histopathological grade and T stage of the tumour. Working with a pilot dataset of 20 images, an experienced radiologist carefully annotated the supraglottic lesions in the three-dimensional plane. Over 280 radiomic features that quantify the shape, intensity and texture were extracted from each image. Machine learning classifiers were built and tested to predict the stage and grade of the malignant tumour based on the calculated radiomic features. To investigate if radiomic features extracted from CT images can be used for the classification of laryngeal tumours. Out of 280 features extracted from every image in the dataset, it was found that 24 features are potential classifiers of laryngeal tumour stage and 12 radiomic features are good classifiers of histopathological grade of the laryngeal tumor. The novelty of this paper lies in the ability to create these classifiers before the surgical biopsy procedure, giving the clinician valuable, timely information.
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