Dual modality PET-CT imaging provides aligned anatomical (CT) and functional (PET) images in a single scanning
session, which can potentially be used to improve image segmentation of PET-CT data. The ability to distinguish
structures for segmentation is a function of structure and modality and varies across voxels. Thus optimal contribution of
a particular modality to segmentation is spatially variant. Existing segmentation algorithms, however, seldom account for
this characteristic of PET-CT data and the results using these algorithms are not optimal. In this study, we propose a
relative discrimination index (RDI) to characterize the relative abilities of PET and CT to correctly classify each voxel
into the correct structure for segmentation. The definition of RDI is based on the information entropy of the probability
distribution of the voxel's class label. If the class label derived from CT data for a particular voxel has more certainty
than that derived from PET data, the corresponding RDI will have a higher value. We applied the RDI matrix to balance
adaptively the contributions of PET and CT data to segmentation of brain PET-CT images on a voxel-by-voxel basis,
with the aim to give the modality with higher discriminatory power a larger weight. The resultant segmentation approach
is distinguished from traditional approaches by its innovative and adaptive use of the dual-modality information. We
compared our approach to the non-RDI version and two commonly used PET-only based segmentation algorithms for
simulation and clinical data. Our results show that the RDI matrix markedly improved PET-CT image segmentation.
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