| 胡彩容,林小艺,阴晓娟,李金銮,吴君心,张秀春.自动勾画软件在食管癌中的应用[J].中华放射医学与防护杂志,2018,38(9):684-689 |
| 自动勾画软件在食管癌中的应用 |
| Application of autosegmentation software in esophageal cancer |
| 投稿时间：2018-03-19 |
| DOI：10.3760/cma.j.issn.0254-5098.2018.09.009 |
| 中文关键词: 自动勾画 食管癌 危及器官 几何学 剂量学 |
| 英文关键词:Autosegmentation Esophageal Cancer Organ-at-risk Geometric Dosimetric |
| 基金项目:福建省医学创新课题（2014-CXB-5）；国家临床重点专科建设项目；福建省临床重点专科建设项目 |
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| 中文摘要: |
| 目的 评估自动勾画软件勾画胸部肿瘤食管癌重要危及器官（OAR）轮廓的几何学及剂量学精度，探讨自动勾画方式应用于食管癌的可行性。方法 选择10例食管癌患者作为研究对象，采用单模板及多模板两种方式对目标CT图像行基于图像配准的相应OAR自动勾画。采用Wilcoxon符号秩和检验比较两种勾画方式与手工勾画的几何学一致性，包括体积差异（ΔV）、形状一致性（DSC）及位置差异指标（Δx、Δy、Δz），并分析形状一致性与体积大小之间的相关性。运用Friedman检验，比较所勾画OAR的剂量分布情况，综合评估自动勾画方式应用于临床的可行性。结果 单模板和多模板两种自动勾画方式得到的总体OAR的平均DSC值分别为0.82±0.17和0.92±0.05，且两组差异具有统计学意义（Z=-2.803~-2.497，P<0.05）。自动勾画方式的形状一致性与OAR体积大小具有正相关性，对体积较小的脊髓，单模板的几何学精度欠佳。多模板勾画的OAR在3个方向上的平均位置偏差在0.5 cm以内，均小于单模板。手工、单模板和多模板的主要剂量指标：全肺V20分别为23.2%、22.4%、22.1%；Dmean分别（11.3±4.0）、（11.1±4.5）和（11.0±4.3）Gy。脊髓Dmax分别为（40.3±4.8）、（38.2±6.7）和（39.4±5.3）Gy。心脏V30分别为16.0%、15.8%和15.5%。3者的剂量分布差异无统计学意义（P>0.05），且各项剂量学指标均符合临床对食管癌OAR的剂量限制要求。结论 自动勾画软件对于食管癌患者的OAR能够达到满意的勾画精度，其中多模板勾画方式优于单模板，更适用于临床。 |
| 英文摘要: |
| Objective To evaluate the geometric and dosimetric accuracy of autosegmentation software for contouring the organ-at-risk (OAR) of esophageal cancer, and discuss its clinical feasibility. Methods A total of 10 patients were enrolled, and single and multi-template were adopted respectively to auto-delineate corresponding OARs on target CT images based on image registration. The geometric consistency including volume difference (ΔV), dice similarity (DSC) and position difference (Δx, Δy, Δz) between the two autosegmentation method and manual were compared using Wilcoxon signed-rank test. And the correlation between DSC and OAR volume was analyzed. In addition, to evaluate the clinical feasibility of autosegmentation, the dose distributions of all OARs were compared using Friedman test. Results The average DSC of all OARs obtained by single and multi-template were 0.82±0.17 and 0.92±0.54, respectively, with statistically significant difference (Z=-2.803- -2.497, P<0.05). A positive correlation between DSC of the autosegmentation and OAR volume was found by spearman analysis, and the single-template was not good enough for the spinal cord with smaller volume. The positional deviations of multi-template group were less than 0.5 cm in three directions, which were better than single-template group. The main dosimetric indexes of single-template and multiple-template were similar to manual coutours. V20 of whole lung were 23.2%, 22.4% and 22.1%, Dmean of whole lung were (11.3±4.0), (11.1±4.5) and (11.0±4.3) Gy, Dmax of spinal cord were (40.3±4.8), (38.2±6.7) and (39.4±5.3) Gy, respectively, and V30 of heart were 16.0%, 15.8% and 15.5%, respectively. There was no statistical difference between the three methods (P>0.05), and all of the dosimetric indexes were in line with the requirements of clinical dose limits. Conclusions The autosegmentation software can achieve satisfactory precision for the OARs of the esophageal cancer patients, and the multi-template method is better than the single-template, which is more suitable for clinical application. |
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