UNet‐based multi‐organ segmentation in photon counting CT using virtual monoenergetic images

Abstract Background Multi‐organ segmentation aids in disease diagnosis, treatment, and radiotherapy. The recently emerged photon counting detector‐based CT (PCCT) provides spectral information of the organs and the background tissue and may improve segmentation performance. Purpose We propose UNet‐based multi‐organ segmentation in PCCT using virtual monoenergetic images (VMI) to exploit spectral information effectively. Methods The proposed method consists of the following steps: Noise reduction in bin‐wise images, image‐based material decomposition, generating VMIs, and deep learning‐based segmentation. VMIs are synthesized for various x‐ray energies using basis images. The UNet‐based networks (3D UNet, Swin UNETR) were used for segmentation, and dice similarity coefficients (DSC) and 3D visualization of the segmented result were evaluation indicators. We validated the proposed method for the liver, pancreas, and spleen segmentation using abdominal phantoms from 55 subjects for dual‐ and quad‐energy bins. We compared it to the conventional PCCT‐based segmentation, which uses only the (noise‐reduced) bin‐wise images. The experiments were conducted on two cases by adjusting the dose levels. Results The proposed method improved the training stability for most cases. With the proposed method, the average DSC for the three organs slightly increased from 0.933 to 0.95, and the standard deviation decreased from 0.066 to 0.047, for example, in the low dose case (using VMIs v.s. bin‐wise images from dual‐energy bins; 3D UNet). Conclusions The proposed method using VMIs improves training stability for multi‐organ segmentation in PCCT, particularly when the number of energy bins is small.