The influence of automation on tumor contouring

Fully or semi-automatic contouring tools are increasingly being used in the tumor contouring task for radiotherapy. While the fully automatic contouring tools have not reached sufficient efficiency, the semi-automatic contouring tools balance more effectively between the human interaction and automation. This study evaluates the influences of a semi-automation contouring tool, called between-slice interpolation, on the resulting contours and the contouring process. The tumor contouring study was conducted on three patient cases with five physicians in a naturalistic setting. The contouring task consisted of initiating the 2D contour manually or with the interpolation tool and correcting that initial contour. The similarity of the resulting contours was pairwise measured within the manual or the interpolated category. Interactions with the software were recorded, and variations in the contouring workflows steps were compared. Results indicated that using the between-slice interpolation tool for creating the initial contour, instead of initiating it manually, influenced both the contouring process and outcomes. First, it was identified that contours initiated by the interpolation tool showed an increased similarity among themselves compared to the manually initiated contours. At the same time, influences to the resulting contours were below clinical relevance, and toward the desired direction—improved consistency of contours. Second, when interpolation was used, in two cases out of three, the average contouring time also decreased significantly. Therefore, the use of such an automation tool can be encouraged.