| 莫少玲,刘懿梅,杨鑫,何立儒,黄思娟.基于磁共振图像手工勾画宫颈癌危及器官稳定性分析[J].中华放射医学与防护杂志,2020,40(9):674-678 |
| 基于磁共振图像手工勾画宫颈癌危及器官稳定性分析 |
| Robustness of MRI-based manual segmentation of organs at risk for cervical cancer |
| 投稿时间：2020-01-10 |
| DOI：10.3760/cma.j.issn.0254-5098.2020.09.004 |
| 中文关键词: 人工勾画 宫颈癌 核磁共振 危及器官 |
| 英文关键词:Manually segmentation Cervical cancer Magnetic resonance image Organs-at-risk |
| 基金项目:广东省自然科学基金（2017A030310217） |
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| 摘要点击次数: 2373 |
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| 中文摘要: |
| 目的 以宫颈癌MR图像为基础，分析不同勾画者、同一勾画者不同时间手工勾画危及器官（OARs）的稳定性，为放疗计划设计的序列选择进行初步探索。方法 回顾性分析中山大学肿瘤防治中心放疗科2016—2018年经MR-sim扫描的30例宫颈癌患者，选取共有的T1WI、T1dixonc和T2WI 3序列MR图像导入Monaco计划系统，由两位临床放疗医师独立在每个患者3个序列上分别勾画膀胱、直肠、肛管、左/右股骨头。其中一位医师在完成首次勾画工作后的一个月再次完成T1WI序列及各OARs的勾画。统计分析各OARs的相似性系数（DSC）、豪斯多夫距离（HD）和位置差异（Δx、Δy、Δz）。结果 不同勾画者在T1WI、T1dixonc、T2WI序列和同一个勾画者在T1WI序列上勾画5个OARs的HD值均<2 mm；位置差异均<5 mm。不同勾画者和同一个勾画者不同时间勾画的DSC、HD及位置差异与OARs体积呈正相关性（R=0.178~0.582，P<0.05）。因肛管体积较小（7.385±1.555）cm3，DSC值均<0.7表现稍差外，其余OARs平均DSC值均>0.82。通过两两比较3个序列上不同勾画者勾画OARs的DSC、HD发现，T1WI序列直肠、左/右股骨头的DSC值、膀胱、左/右股骨头、直肠的HD值以及肛管、右股骨头Δz轴差异均优于T1dixonc，差异有统计学意义（t=-3.116~3.604，P<0.05）；T1WI序列直肠DSC值和肛管HD值较T2WI序列好（t=2.934、3.677，P<0.05）；T1dixonc序列直肠DSC、肛管HD差异稍优于T2WI（t=6.806、2.130，P<0.05）；T2WI序列勾画骨组织（左/右股骨头）稳定性优于T1WI、T1dixonc，且差异均具有统计学意义（t=-6.580~6.542，P<0.05）。结论 基于MR图像的不同勾画者和同一勾画者不同时间勾画膀胱、直肠、股骨头稳定性较好，肛管次之。且T1WI序列OARs勾画稳定性较优于T1dixonc、T2WI。 |
| 英文摘要: |
| Objective The aim of the study is to investigate the inter-observer and intra-observer precision in manually segmentation of organs-at-risk(OARs) for cervical cancer on the basis of MR image, and to preliminarily explore sequence selection designed for radiotherapy planning. Methods Thirty cervical cancer patients scanned by MR-sim from 2016 to 2018 in the department of radiotherapy of Sun Yat-sen university cancer center were retrospectively analyzed. T1WI, T1dixonc and T2WI sequence from MR-simulator were selected and imported into Monaco planning system. Manual segmentation of 5 organs-at-risk (bladder, rectum, anal canal, and left/right femoral head) was done by 2 independent experienced physicians on three sequences acquired from these patients. A month later, the second segmentation of the OARs in the T1WI sequence was done by one of the two physicians. Dice similarity coefficient (DSC), Hausdorff distance (HD) and position difference(Δx, Δy, Δz) of each OAR were used to analyze the robustness of inter-observer and intra-observer segmentation OARs. Results The HD values of five OARs segmentation by the two physicians in T1WI, T1dixonc and T2WI sequences and the same physician in T1WI at different time were all less than 2 mm; the position differences were less than 5 mm. The DSC values, HD values and difference position values of the two physician and the same physician at different time was positively correlated with the volume of OARs (R=0.178-0.582, P<0.05). Due to the small volume of the anal canal (7.385±1.555) cm3, the DSC values were less than 0.7 and the performance was slightly worse. The average DSC values of other OARs were all greater than 0.82. Comparing the DSC, HD and position differences of OARs in the three sequences, DSC values of rectum, left/right femoral head and bladder, HD values of left/right femoral head and rectum, and Δz axis difference of anal canal and right femoral head of T1WI sequence were better than T1dixonc (t=-3.116-3.604, P<0.05); DSC value of rectum and HD value of anal canal in T1WI sequence were better than T2WI sequence(t=2.934, 3.677,P<0.05);T1dixonc sequence rectal DSC, right femoral head Δz axis difference were slightly better than T2WI(t=6.806,2.130,P<0.05). T2WI sequence bone tissue (left/right femoral head) stability was better than T1WI, T1dixonc, and the difference was statistically significant (t=-6.580-6.542,P<0.05). Conclusions From three index of DSC, HD and position difference, the robustness of inter-observer and intra-observer segmentation of bladder, rectum and femoral head are fine based on MR sequence, followed by anal canal. In addition, the robustness of OARs segmentation by T1WI sequence is better than that of T1dixonc and T2WI sequence. |
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