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曹安宁, 嵇卫星, 马秀瑞, 等. 外扩胃和十二指肠轮廓提高放射治疗自动勾画安全性的效果[J]. 中国临床医学, 2022, 29(6): 1017-1021. DOI: 10.12025/j.issn.1008-6358.2022.20221162
引用本文: 曹安宁, 嵇卫星, 马秀瑞, 等. 外扩胃和十二指肠轮廓提高放射治疗自动勾画安全性的效果[J]. 中国临床医学, 2022, 29(6): 1017-1021. DOI: 10.12025/j.issn.1008-6358.2022.20221162
CAO An-ning, JI Wei-xing, MA Xiu-rui, et al. Effect of expanding stomach and duodenum to improve the safety of auto-contouring in radiotherapy[J]. Chin J Clin Med, 2022, 29(6): 1017-1021. DOI: 10.12025/j.issn.1008-6358.2022.20221162
Citation: CAO An-ning, JI Wei-xing, MA Xiu-rui, et al. Effect of expanding stomach and duodenum to improve the safety of auto-contouring in radiotherapy[J]. Chin J Clin Med, 2022, 29(6): 1017-1021. DOI: 10.12025/j.issn.1008-6358.2022.20221162

外扩胃和十二指肠轮廓提高放射治疗自动勾画安全性的效果

Effect of expanding stomach and duodenum to improve the safety of auto-contouring in radiotherapy

  • 摘要:
    目的 探讨自动勾画的危及器官(organ at risk, OAR)外扩对各类型剂量评估参数的影响。
    方法 收集2019年至2021年复旦大学附属中山医院放疗科收治的接受上腹部放疗的50例患者的CT图像,自动和人工勾画胃和十二指肠。采用Mann-Whitney U检验评估胃和十二指肠自动勾画戴斯相似系数(Dice similarity coefficient, DSC)、95%豪斯多夫距离(95% Hausdorff distance, HD95)的差异。结合临床常用剂量分布,计算胃和十二指肠自动勾画与人工勾画的剂量差异。采用Wilcoxon秩和检验评估不同外扩距离引起的剂量评估参数差异的变化。采用bootstrap法计算各差异均值95%CI的下限。分析所需的最小外扩距离,使得外扩后的结构所对应的剂量评估参数大于或等于手动勾画OAR的剂量评估参数。
    结果 胃的DSC和HD95均优于十二指肠,差异有统计学意义(P<0.001)。相邻外扩距离引起的最高剂量差异有统计学意义(P<0.001)。在DSC>0.8情况下,外扩约7mm可以保证外扩结构的最高剂量大于或等于手动勾画OAR;外扩5mm可以保证即使外扩结构的最高剂量低于人工勾画OAR,其差异也不会超过1 Gy。
    结论 随着自动勾画OAR的外扩,最高剂量差异发生变化,而平均剂量和V30差异不发生变化;外扩一定距离可以保证外扩后的结构所对应的最高剂量大于等于人工勾画OAR对应的最高剂量。

     

    Abstract:
    Objective To explore the effect of the expansion of auto-contouring organ at risk (OAR) on various dose evaluation parameters.
    Methods The stomach and duodenum were automatically and manually contoured on the CT scans of 50 individuals who had upper abdominal radiotherapy from 2019 to 2021. Mann-Whitney U test was used to assess the difference in auto-contouring results between stomach and duodenum in terms of Dice similarity coefficient (DSC) and 95% Hausdorff distance (HD95). To calculate the dose difference between the auto-contouring and manually contouring with the clinically applied dose distribution. The Wilcoxon rank-sum test was utilized to evaluate the variation of the dose evaluation parameters caused by the different expansion distance. The lower limit of the 95% confidence interval for each difference averages was calculated by bootstrap method. The minimum expansion distance required when the dose evaluation parameter corresponding to the expanded structure was greater than or equal to that for the manual contoured OAR was analyzed.
    Results The DSC and HD95 of stomach were superior to those of the duodenum and there was a significant difference (P < 0.001). There were significant differences in the maximum doses induced by adjacent expansion procedures (P < 0.001). Under the condition of DSC > 0.8, the maximum dose of the expanded structure was larger than or equal to the manually contoured OAR when the outer expansion was around 7 mm; and the difference was not be greater than 1 Gy, even if it was less than the OAR that was manually contoured when the outer expansion was 5 mm.
    Conclusions The maximum dose would change as the auto-contoured OAR expanding, while the mean dose and V30 would not. A certain distance of expansion could ensure that the maximum dose corresponding to the expanded structure is greater than or equal to the maximum dose corresponding to the manually contoured OAR.

     

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