放射性肺损伤与三维剂量分布的相关性研究  

Correlation between radiation-induced lung injury and 3D dose distribution

作　　者：范晓鸿 董可 杨银[1] 张建平 FAN Xiaohong;DONG Ke;YANG Yin;ZHANG Jianping(School of Mathematics and Computational Science,Xiangtan University,Xiangtan 411105,China;Department of Radiotherapy,Xiangtan Central Hospital,Xiangtan 411101,China)

机构地区：[1]湘潭大学数学与计算科学学院,湖南湘潭411105 [2]湘潭市中心医院放疗科,湖南湘潭411101

出　　处：《中国医学物理学杂志》2021年第6期692-698,共7页Chinese Journal of Medical Physics

基　　金：国家自然科学基金(11771369,11671342);湖南省教育厅优秀青年基金(17B257);湖南省自然科学基金(2018JJ2375)。

摘　　要：目的:应用影像组学开展肺癌患者放射性肺损伤与放疗计划剂量分布相关性分析的研究,筛选出与放疗CT影像改变相关联的特征。方法:选取放疗后参与随访的肺癌患者18例,通过计划和诊断CT之间的配准变形场得到相应诊断CT的剂量分布;将对侧肺与同侧肺及各设定剂量区间内的肺实质分割为相应感兴趣区并提取其影像组学特征,计算治疗前后特征改变量,比较特征改变量在不同剂量区间、时间节点下的差异并筛选特征。结果:(1)筛选出28个特征的筛查剂量响应曲线在放疗第2周与放疗第4、6及10周有较明显差异,而放疗第4周与第6、10周整体差异较小;(2)筛选出27个特征的肺损伤剂量响应曲线在低剂量区(0~20 Gy)或高剂量区(45~65 Gy)响应较强烈,且随放疗后时间越久特征改变量越大;(3)筛选出15个特征在对侧肺与同侧肺的特征改变量有较明显分层现象。结论:通过分析肺癌患者放疗前后影像组学特征改变量,证实了放射性肺损伤与三维剂量分布具有显著相关性。追踪这些特征的动态变化,对评估放射性肺损伤随时间及位置的发展规律有潜在优势。Objective To analyze the correlation between radiation-induced lung injury and dose distribution in lung cancer patients by radiomics,and to determine the features related to CT image changes.Methods A total of 18 lung cancer patients who were followed-up after radiotherapy were enrolled in the study.The dose distribution of diagnostic CT was obtained from the deformation of planned CT dose distribution using the registration deformation field between planned CT and diagnostic CT.The ipsilateral and contralateral lungs and segmented lung parenchyma for each dose rang were considered as the regions of interest,and the radiomics features were extracted.The feature changes between before and after treatment were compared at different dose ranges and time,and the features with distinct differences were screened out.Results According to the dose-response curves of screening,28 features at the 2nd week after radiotherapy which were significantly different from those at the 4th,6th and 10th week after radiotherapy were selected,while the overall differences between the 4th week of radiotherapy and the 6th,10th weeks after radiotherapy were relatively small.According to the dose-response curves of lung injury,27 features which had stronger dose responses in the low dose area(0-20 Gy)or the high dose area(45-65 Gy)were selected,and the feature changes were larger with the longer time after radiotherapy.For the ipsilateral and contralateral lungs,15 features which were obviously stratified were screened out.Conclusion By analyzing the features changes of lung cancer patients before and after radiotherapy,the significant correlation between radiation lung injury and three-dimensional dose distribution is confirmed.Monitoring the dynamic changes of these features has potential advantages in assessing the pattern of radioactive lung injury over time.

关 键 词：肺癌 剂量分布 影像组学 特征筛选 放射性肺损伤 

分 类 号：R318[医药卫生—生物医学工程] R818.8[医药卫生—基础医学]