自动勾画临床靶区和危及器官用于制定早期乳腺癌保乳术后放疗计划  

Automatic delineating clinical target volume and organ at risk for designing radiotherapy plan after breast conserving surgery for early breast cancer

作　　者：龚筱钦 陈飞[1] 胡静[1] 杨灵杰 戴春华[1] 张开军[1] 游涛[1,3] GONG Xiaoqin;CHEN Fei;HU Jing;YANG Lingjie;DAI Chunhua;ZHANG Kaijun;YOU Tao(Department of Radiation Oncology,Affiliated Hospital of Jiangsu University,Zhenjiang,212000,China;Department of Ultrasound,the 63680 Military Hospital of Chinese People's Liberation Army,Wuxi 214400,China;Department of Radiation Oncology,the Fourth Division Hospital of Xinjiang Production and Construction Corps,Yili 835000,China)

机构地区：[1]江苏大学附属医院放疗科,江苏镇江212000 [2]中国人民解放军63680部队医院超声科,江苏无锡214400 [3]新疆生产建设兵团第四师医院放疗科,新疆伊犁835000

出　　处：《中国医学影像技术》2023年第7期1075-1079,共5页Chinese Journal of Medical Imaging Technology

基　　金：江苏省卫健委医学科研基金重点项目(ZDB2020022);新疆生产建设兵团第四师可克达拉市科技计划。

摘　　要：目的观察自动勾画临床靶区(CTV)和危及器官(OAR)用于制定乳腺癌保乳术后放疗计划的可行性。方法选取52例女性早期右侧乳腺癌保乳术后患者,由医师于胸部CT图像中手动勾画CTV和OAR。采用AccuLearning^(TM)软件对其中40例(训练集)CT图像进行训练,生成自动勾画模型,并以之对其余12例(测试集)CT图像进行自动勾画,辅以手动修改获得CTV及OAR;分别根据手动和自动勾画的CTV和OAR制定放疗计划,即Plan-RS和Plan-DL,对比其CTV及OAR剂量学参数及勾画时间。结果测试集Plan-RS与Plan-DL的CTV剂量学参数差异均无统计学意义(P均>0.05);二者间健侧肺、心脏及健侧乳腺的平均放疗剂量(D_(mean))差异有统计学意义(P均<0.05),其余OAR剂量学参数差异均无统计学意义(P均>0.05)。手动勾画和自动勾画CTV平均用时分别为1006 s和239 s,前者长于后者(P<0.05);除脊髓外,自动勾画其他OAR用时较手动勾画缩短(P均<0.001)。结论自动勾画CTV和OAR可用于制定乳腺癌保乳术后放疗计划。Objective To explore the feasibility of automatic delineating clinical target volume(CTV)and organ at risk(OAR)in designing radiotherapy plans for early breast cancer after breast conserving surgery.Methods Fifty-two female early right breast cancer patients after breast conserving surgery were enrolled.CTV and OAR were delineated on chest CT images by a physician.CT images(training set)of 40 cases were randomly selected and trained on AccuLearning^(TM)platform to generate an automatic delineating model,which was used to automatically delineated CTV(with manual modification by the physician)and OAR for remaining 12 cases(test set).The radiotherapy plans were designed according to manual and automatic delineation of CTV(with physician manual modification)and OAR,and the generated plans were named Plan-RS and Plan-DL,respectively.The dose parameters and delineating time of CTV and OAR were compared between Plan-RS and Plan-DL.Results In the test set,no significant difference of dose parameters of CTV was found between Plan-RS and Plan-DL(all P>0.05),while there were significant differences of the mean radiotherapy dose(D_(mean))of lung of healthy side,heart and breast of healthy side between groups(all P<0.05),but not of other dose parameters of OAR(all P>0.05).The average time of manual delineation,automatic delineation of CTV was 1006 s and 239 s,respectively,the former was longer than the latter(P<0.05).Except for spinal cord,the time of automatic delineation were shorter than that of manual delineation of OAR(all P<0.001).Conclusion Automatic delineating CTV and OAR were feasible for designing postoperative radiotherapy plans after breast conserving surgery for breast cancer.

关 键 词：乳腺肿瘤 放射治疗 体层摄影术 X线计算机 自动勾画 

分 类 号：R737.9[医药卫生—肿瘤] R814.42[医药卫生—临床医学]