In this study, we evaluate the performance of the Segment Anything Model
(SAM) model in clinical radiotherapy. We collected real clinical cases from
four regions at the Mayo Clinic: prostate, lung, gastrointestinal, and head \&
neck, which are typical treatment sites in radiation oncology. For each case,
we selected the OARs of concern in radiotherapy planning and compared the Dice
and Jaccard outcomes between clinical manual delineation, automatic
segmentation using SAM's "segment anything" mode, and automatic segmentation
using SAM with box prompt. Our results indicate that SAM performs better in
automatic segmentation for the prostate and lung regions, while its performance
in the gastrointestinal and head \& neck regions was relatively inferior. When
considering the size of the organ and the clarity of its boundary, SAM displays
better performance for larger organs with clear boundaries, such as the lung
and liver, and worse for smaller organs with unclear boundaries, like the
parotid and cochlea. These findings align with the generally accepted
variations in difficulty level associated with manual delineation of different
organs at different sites in clinical radiotherapy. Given that SAM, a single
trained model, could handle the delineation of OARs in four regions, these
results also demonstrate SAM's robust generalization capabilities in automatic
segmentation for radiotherapy, i.e., achieving delineation of different
radiotherapy OARs using a generic automatic segmentation model. SAM's
generalization capabilities across different regions make it technically
feasible to develop a generic model for automatic segmentation in radiotherapy.

本研究中，我们评估了 SAM 模型在临床放射治疗中的表现。SAM 在前列腺和肺区域的自动分割表现较好，而在胃肠和头颈区域的表现相对较差。然而，这些结果表明 SAM 对于使用单个训练模型完成四个区域的器官边界识别具有鲁棒的泛化能力。