Three-dimensional prostate CT segmentation through fine-tuning of a pre-trained neural network using no reference labeling

Accurate segmentation of the prostate on computed tomography (CT) has many diagnostic and therapeutic applications. However, manual segmentation is time-consuming and suffers from high inter- and intra-observer variability. Computerassisted approaches are useful to speed up the process and increase the reproducibility of the segmentation. Deep learningbased segmentation methods have shown potential for quick and accurate segmentation of the prostate on CT images. However, difficulties in obtaining manual, expert segmentations on a large quantity of images limit further progress. Thus, we proposed an approach to train a base model on a small, manually-labeled dataset and fine-tuned the model using unannotated images from a large dataset without any manual segmentation. The datasets used for pre-training and finetuning the base model have been acquired in different centers with different CT scanners and imaging parameters. Our fine-tuning method increased the validation and testing Dice scores. A paired, two-tailed t-test shows a significant change in test score (p = 0.017) demonstrating that unannotated images can be used to increase the performance of automated segmentation models.