| 刘礼东,杨振,邱小平,等.食管癌调强计划三维剂量验证中γ通过率最佳阈值的研究[J].中华放射医学与防护杂志,2018,38(4):297-301.Liu Lidong,Yang Zhen,Qiu Xiaoping,et al.The optimal gamma passing rate thresholds of IMRT dosimetric verification in the treatment of esophageal cancer[J].Chin J Radiol Med Prot,2018,38(4):297-301 |
| 食管癌调强计划三维剂量验证中γ通过率最佳阈值的研究 |
| The optimal gamma passing rate thresholds of IMRT dosimetric verification in the treatment of esophageal cancer |
| 投稿时间：2017-09-26 |
| DOI：10.3760/cma.j.issn.0254-5098.2018.04.010 |
| 中文关键词: 调强放疗 受试者工作特征曲线 最佳阈值 剂量体积直方图 |
| 英文关键词:Intensity-modulated radiotherapy Receiver operating characteristic curve Optimal thresholds Dose volume histogram |
| 基金项目:国家自然科学基金（61772555） |
| 作者 | 单位 | E-mail | | 刘礼东 | 421001 衡阳, 南华大学核科学技术学院 | | | 杨振 | 410008 长沙, 中南大学湘雅医院肿瘤科 | yangzhen@188.com | | 邱小平 | 421001 衡阳, 南华大学核科学技术学院 | | | 赵于前 | 410083 长沙, 中南大学信息科学与工程学院 | | | 雷明军 | 410008 长沙, 中南大学湘雅医院肿瘤科 | | | 曹瑛 | 410008 长沙, 中南大学湘雅医院肿瘤科 | | | 杨晓喻 | 410008 长沙, 中南大学湘雅医院肿瘤科 | | | 唐杜 | 410008 长沙, 中南大学湘雅医院肿瘤科 | | | 王翰宇 | 421001 衡阳, 南华大学核科学技术学院 | | | 左宇浩 | 421001 衡阳, 南华大学核科学技术学院 | |
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| 中文摘要: |
| 目的 基于三维剂量验证系统EDoseTM，寻找食管癌调强放疗计划验证中利用γ分析方法判别计划是否通过的最佳阈值。方法 回顾性地选取25例经临床批准的食管癌7野调强计划，使用EdoseTM在计划CT中重建三维剂量，并进行γ分析和剂量体积直方图（DVH）评价。然后，按照以下两个准则对计划分类：DVH特定剂量学指标绝对百分剂量差异<5%视为临床可接受计划。3%/3 mm基准下，γ通过率>90%，认为计划通过。根据分类结果绘制出受试者工作特征（receiver operating characteristic，ROC）曲线，通过计算约登系数的方式寻找全局γ在5%/3 mm、3%/3 mm和2%/2 mm基准下的最佳通过率阈值，并对最佳阈值在计划判别中的敏感性和特异性进行分析。结果 全局5%/3 mm、3%/3 mm和2%/2 mm基准下的最佳阈值分别为98.66%、94.84%和78.56%。在常规阈值90%处，全局3%/3 mm基准下的敏感性和特异性分别为0.17和0.84，而最佳阈值同样条件下的敏感性和特异性分别为0.85和0.27；全局5%/3 mm和2%/2 mm基准下最佳阈值的敏感性分别为0.89和0.65，特异性分别为0.23和0.47。结论 在3%/3 mm基准下最佳阈值较常规阈值（90%）敏感性得到显著提升，提高了阻止不可接受计划通过的能力；在2%/2 mm基准下，最佳阈值的敏感性和特异性更为平衡（相对3%/3 mm基准），一定程度上减少了不可接受计划通过的概率，同时也降低了可接受计划被误判的机会。 |
| 英文摘要: |
| Objective To investigate the optimal gamma passing rate of intensity-modulated radiotherapy (IMRT) dosimetric verification in the treatment of esophageal cancer using a three-dimensional dose verification system EDoseTM. Methods Twenty five esophageal cancer patients treated by 7-field IMRT were retrospectively reviewed. Measured dose distribution were reconstructed on CT image and evaluated by gamma analysis and DVH metrics using the EDoseTM system. Plans with DVH metrics dose difference<5% or with gamma passing > 90% under 3%/3 mm criteria were accepted. The optimal gamma passing rate for criteria of 5%/3 mm, 3%/3 mm, 2%/2 mm were investigated by drawing the receiver operating characteristic(ROC) curves and calculating the Youden Index. The sensitivity and specificity of the these optimal thresholds in the plan verification were also analyzed. Results The optimal thresholds for global gamma indices with 5%/3 mm, 3%/3 mm, 2%/2 mm were 98.66%, 94.84%, 78.56%, respectively. In the 90% common threshold, The sensitivity and specificity for common 90% threshold and optimal threshold under 3%/3 mm criteria were 0.17 vs. 0.85 and t 0.84 vs. 0.27, respectively. The sensitivity and specificity were 0.89, 0.65 and 0.23, 0.47 for optimal thresholds under 5%/3 mm and 2%/2 mm criteria, respectively. Conclusions The sensitivity of optimal threshold gamma passing rate improved significantly compared with the common threshold (90%) at 3%/3 mm criteria.,The sensitivity and the specificity were more balanced at the 2%/2 mm criteria compared with those at 3%/3 mm criteria. |
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