Intraoperative segmentation of iodine and palladium radioactive sources in C-arm images

Chiara Amat di San Filippo, Gabor Fichtinger, William James Morris, Septimiu E. Salcudean, Ehsan Dehghan, Pascal Fallavollita

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Purpose:    Dynamic dosimetry is becoming the standard to evaluate the quality of radioactive implants during brachytherapy. For this, it is essential to obtain a 3D visualization of the implanted seeds and their relative position to the prostate. A method was developed to obtain a robust and precise segmentation of seeds in C-arm images, and this approach was tested using clinical datasets.

Method:    A region-based implicit active contour approach was used to delineate implanted seeds. Then, a template-based matching was employed to segment iodine implants whereas a K-means algorithm is implemented to resolve palladium seed clusters. To validate the method, 55 C-arm images from 10 patients were used for the segmentation of iodine sources, whereas 225 C-arm images from 16 patients were used for the palladium case.

Results:    Compared to manual ground truth segmentation of 6,002 iodine seeds and 15,354 palladium seeds, 98.7 % of iodine sources were automatically detected and declustered showing a false-positive rate of only 1.7 %. A total of 98.7 % of palladium sources were automatically detected and declustered with a false-positive rate of only 2.0 %.

Conclusion:    An automated segmentation method was developed that is able to perform the identification and annotation processes of seeds on par with a human expert. This method was shown to be robust and suitable for integration in the dynamic dosimetry workflow of prostate brachytherapy interventions.

Original languageEnglish (US)
Pages (from-to)769-776
Number of pages8
JournalInternational journal of computer assisted radiology and surgery
Issue number5
StatePublished - Sep 28 2014
Externally publishedYes


  • Brachytherapy
  • C-arm fluoroscopy
  • Declustering
  • Iodine implants
  • Palladium implants
  • Radioactive seeds
  • Segmentation

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Health Informatics
  • Surgery
  • Medicine(all)


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