CloverNet – Leveraging Planning Annotations for Enhanced Procedural MR Segmentation: An Application to Adaptive Radiation Therapy

In radiation therapy (RT), an accurate delineation of the regions of interest (ROI) and organs at risk (OAR) allows for a more targeted irradiation with reduced side effects. The current clinical workflow for combined MR-linear accelerator devices (MR-linacs) requires the acquisition of a planning MR volume (MR-P), in which the ROI and OAR are accurately segmented by the clinical team. These segmentation maps (S-P) are transferred to the MR acquired on the day of the RT fraction (MR-Fx) using registration, followed by time-consuming manual corrections. The goal of this paper is to enable accurate automatic segmentation of MR-Fx using S-P without clinical workflow disruption. We propose a novel UNet-based architecture, CloverNet, that takes as inputs MR-Fx and S-P in two separate encoder branches, whose latent spaces are concatenated in the bottleneck to generate an improved segmentation of MP-Fx. CloverNet improves the absolute Dice Score by 3.73% (relative +4.34%, p<0.001) when compared with conventional 3D UNet. Moreover, we believe this approach is potentially applicable to other longitudinal use cases in which a prior segmentation of the ROI is available.