Three-Dimensional (3-D) imaging is vital in computer-assisted surgical planning including minimal invasive surgery, targeted drug delivery, and tumor resection. Selective Internal Radiation Therapy (SIRT) is a liver directed radiation therapy for the treatment of liver cancer. Accurate calculation of anatomical liver and tumor volumes are essential for the determination of the tumor to normal liver ratio and for the calculation of the dose of Y-90 microspheres that will result in high concentration of the radiation in the tumor region as compared to nearby healthy tissue. Present manual techniques for segmentation of the liver from Computed Tomography (CT) tend to be tedious and greatly dependent on the skill of the technician/doctor performing the task. This dissertation presents the development and implementation of a fully integrated algorithm for 3-D liver and tumor segmentation from tri-phase CT that yield highly accurate estimations of the respective volumes of the liver and tumor(s). The algorithm as designed requires minimal human intervention without compromising the accuracy of the segmentation results. Embedded within this algorithm is an effective method for extracting blood vessels that feed the tumor(s) in order to plan effectively the appropriate treatment. Segmentation of the liver led to an accuracy in excess of 95% in estimating liver volumes in 20 datasets in comparison to the manual gold standard volumes. In a similar comparison, tumor segmentation exhibited an accuracy of 86% in estimating tumor(s) volume(s). Qualitative results of the blood vessel segmentation algorithm demonstrated the effectiveness of the algorithm in extracting and rendering the vasculature structure of the liver. Results of the parallel computing process, using a single workstation, showed a 78% gain. Also, statistical analysis carried out to determine if the manual initialization has any impact on the accuracy showed user initialization independence in the results. The dissertation thus provides a complete 3-D solution towards liver cancer treatment planning with the opportunity to extract, visualize and quantify the needed statistics for liver cancer treatment. Since SIRT requires highly accurate calculation of the liver and tumor volumes, this new method provides an effective and computationally efficient process required of such challenging clinical requirements.

Liver segmentation is a cumbersome task when done manually, often consuming quality time of radiologists. Use of automation in such clinical task is fundamental and the subject of most modern research. Various computer aided methods have been incorporated for this task, but it has not given optimal results due to the various challenges faced as low-contrast in the images, abnormalities in the tissues, etc. As of present, there has been significant progress in machine learning and artificial intelligence (AI) in the field of medical image processing. Though challenges exist, like image sensitivity due to different scanners used to acquire images, difference in imaging methods used, just to name a few. The following research embodies a convolutional neural network (CNN) was incorporated for this process, specifically a U-net algorithm. Predicted masks are generated on the corresponding test data and the Dice similarity coefficient (DSC) is used as a statistical validation metric for performance evaluation. Three datasets, from different scanners (two1.5 T scanners and one 3.0 T scanner), have been evaluated. The U-net performs well on the given three different datasets, even though there was limited data for training, reaching upto DSC of 0.93 for one of the datasets.