Anisotropic 3D Multi-Stream CNN for Accurate Prostate Segmentation from Multi-Planar MRI

Background and Objective: Accurate and reliable segmentation of the prostate gland in MR images can support the clinical assessment of prostate cancer, as well as the planning and monitoring of focal and loco-regional therapeutic interventions. Despite the availability of multi-planar MR scans due to standardized protocols, the majority of segmentation approaches presented in the literature consider the axial scans only. Methods: We propose an anisotropic 3D multi-stream CNN architecture, which processes additional scan directions to produce a higher-resolution isotropic prostate segmentation. We investigate two variants of our architecture, which work on two (dual-plane) and three (triple-plane) image orientations, respectively. We compare them with the standard baseline (single-plane) used in literature, i.e., plain axial segmentation. To realize a fair comparison, we employ a hyperparameter optimization strategy to select optimal configurations for the individual approaches. Results: Training and evaluation on two datasets spanning multiple sites obtain statistical significant improvement over the plain axial segmentation ($p<0.05$ on the Dice similarity coefficient). The improvement can be observed especially at the base ($0.898$ single-plane vs. $0.906$ triple-plane) and apex ($0.888$ single-plane vs. $0.901$ dual-plane). Conclusion: This study indicates that models employing two or three scan directions are superior to plain axial segmentation. The knowledge of precise boundaries of the prostate is crucial for the conservation of risk structures. Thus, the proposed models have the potential to improve the outcome of prostate cancer diagnosis and therapies.