In breast-conserving surgery (BCS) radiotherapy for breast cancer (BC), clinical target volume (CTV) and organs at risk (OARs) on CT images are mainly manually delineated layer by layer by radiation oncologists (RO), a time-consuming process prone to variability due to clinical experience differences and inter- and intra-observer variations. To address this, we developed a new automatic delineation model aimed at medical CT images, specifically for computer-assisted medical detection and diagnosis. The CT scans of 100 patients who underwent BCS and radiotherapy were collected. These data were used to create, train, and validate a new deep-learning (DL) model, the MSBC-Segformer (Multi-Scale Boundary-Constrained Segmentation Model Based on Transformer) model, which was proposed to automatically segment the CTV and OARs. The Dice Similarity Coefficient (DSC) and 95th percentile Hausdorff Distance (95HD) were used to evaluate the effectiveness of the proposed model. In result, the MSBC-Segformer model can provide accurate and efficient delineation of CTV and OARs for BC patients underwent radiotherapy after BCS, outperforming both junior doctors and almost all other existing CNN models, and reducing the instability of segmentation results due to observer differences, thus significantly enhancing clinical efficiency. Moreover, evaluation by three ROs revealed no significant difference between the model and manual delineation by the senior doctors ( for CTV and for OARs). The model significantly reduced segmentation time, with an average of only 12.53 s per patient.
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