Boundary delineation in transrectal ultrasound images for region of interest of prostate.

Accurate and robust prostate segmentation in transrectal ultrasound (TRUS) images is of great interest for ultrasound-guided brachytherapy for prostate cancer. However, the current practice of manual segmentation is difficult, time-consuming, and prone to errors. To overcome these challenges, we developed an accurate prostate segmentation framework (A-ProSeg) for TRUS images. The proposed segmentation method includes three innovation steps: (1) acquiring the sequence of vertices by using an improved polygonal segment-based method with a small number of radiologist-defined seed points as prior points; (2) establishing an optimal machine learning-based method by using the improved evolutionary neural network; and (3) obtaining smooth contours of the prostate region of interest using the optimized machine learning-based method. The proposed method was evaluated on 266 patients who underwent prostate cancer brachytherapy. The proposed method achieved a high performance against ground truth with a Dice similarity coefficient (DSC) of 96.2% ± 2.4%, a Jaccard similarity coefficient (Ω) of 94.4% ± 3.3%, and an accuracy (ACC) of 95.7% ± 2.7%, which are all higher than the state-of-the-art methods. Sensitivity evaluation on different noise levels demonstrated that our method achieved high robustness against changes in image quality. Meanwhile, an ablation study was performed, and the significance of all the key components of the proposed method was demonstrated.