Skull is the anatomic landmark for patient set up of head radiation therapy. Skull is generally segmented from CT images because CT provides better definition of skull than MR imaging. In the mean time, radiation therapy is planned on MR images for soft tissue information. This study utilized a knowledge-guided active model (KAM) method to segmented skull on MR images in order to enable radiation therapy planning with MR images as the primary planning dataset. KAM utilized age-specific skull

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... h models that segmented from CT images using a conditional region growing algorithm. Skull models were transformed to given MR images using an affine registration algorithm based on normalized mutual information. The transformed mesh models actively located skull boundaries by minimizing their total energy. The preliminary validation was performed on MR and CT images from five patients. The KAM segmented skulls were compared with those segmented from CT images. The average image similarity (kappa index) was 0.57. The initial validation showed that it was promising to segment skulls directly on MR images using KAM.