人工勾画与三种自动勾画方法对食管癌放射治疗危及器官勾画结果的比较研究  

Comparative study of the results of manual delineation and three methods for automatic segmentation of organs at risk in the esophageal cancer

作　　者：肖剑波 杨明俊 陈旭澜 谢力 马代远[1,2] 马强[1] 张洪攀[1,2] 皈燕 XIAO Jian-bo;YANG Ming-jun;CHEN Xu-lan;XIE Li;MA Dai-yuan;GUI Yan(North Sichuan Medical College;Department of Oncology,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,Sichuan,China)

机构地区：[1]川北医学院 [2]川北医学院附属医院肿瘤科,四川南充637000

出　　处：《川北医学院学报》2024年第11期1442-1447,共6页Journal of North Sichuan Medical College

基　　金：国家自然科学基金(82271959);四川省南充市市校科技战略合作专项(20SXQT0254)。

摘　　要：目的:通过比较和分析基于增强CT图像的人工手动勾画与三种自动勾画软件[PVmed、United Imaging(UI)、MIM Maestro 7.1.4(MIM)]在食管癌放疗中危及器官(OARs)的勾画的精确度,评估不同勾画方式在食管癌放射治疗靶区勾画中的优劣性及应用价值。方法:回顾性分析在川北医学院附属医院放疗科接受根治性放疗的20例食管癌患者模拟西部CT定位图像,先由高年资放疗医师在患者增强定位CT图像上手动勾画,再用自动勾画软件进行勾画。分别计算不同勾画方式的豪斯多夫距离(HD)、平均最小距离(MDA)、形状相似性指数(DSC)及相似性(JC),并对勾画结果几何量化评价参数汇总并进行统计学分析。结果:3种自动勾画软件对心脏、肝脏、左右肺及脊髓勾画效果较好,其DSC值均>0.8,其中心脏、肝脏、肺等器官JC值均>0.8;对于心脏的勾画,三组危及器官HD与MDA无明显差异,但MIM要优于其它两者;对于肝脏的勾画与心脏相反,PVmed、UI要优于MIM。虽然三种勾画软件在双肺的效果可观,但其HD值比较:PVmed<MIM<UI,分别为(26.828、28.371、35.004),其中PVmed优于UI(P<0.001);三种软件对于脊髓的勾画较人工勾画DSC无明显差异(DSC值均<0.7,P=0.239),但JC值均<0.8,其中HD值比较:UI<PVmed<MIM;而对于体积较小的甲状腺的勾画效果较差,其DSC值<0.8、JC值<0.7,PVmed和MIM均优于UI,且三种自动勾画软件HD与MDA有统计学意义(P=0.048;P<0.001),其中PVmed和MIM明显优于UI。结论:基于人工智能技术的放疗危及器官自动勾画软件(PVmed、UI、MIM)在食管癌OARs勾画对于心脏、肝脏、肺、脊髓等器官勾画准确性较高,但对于甲状腺的勾画UI、MIM软件较PVmed精度需人工手动修改,提高食管癌放疗靶区勾画的准确性。Objective:By comparing and analyzing the accuracy of manual mapping based on enhanced CT images and three kinds of automatic mapping software[PVmed,United Imaging(UI),MIM Maestro 7.1.4(MIM)]in the mapping of Organs at Risk(OARs)in esophageal cancer radiotherapy,to evaluate the advantages and disadvantages of different delineation methods in the delineation of targets for radiotherapy of esophageal cancer.Methods:The simulated CT images of 20 patients with esophageal cancer who received radical radiotherapy in the radiotherapy Department of the Affiliated Hospital of North Sichuan Medical College were retrospectively analyzed.The enhanced CT images were manually outlined by senior radiotherapy doctors and then outlined by automatic sketch software.The Hausdorff distance(HD),mean minimum distance(MDA),Dice Similarity Coefficient(DSC)and Jaccard Coefficient(JC)of different delineation methods were calculated,and the geometric quantitative evaluation parameters of the delineation results were summarized and analyzed statistically.Results:Three kinds of automatic delineation software had better delineation effect on the heart,liver,left and right lung and spinal cord.DSC all>0.8,and JC values of heart,liver,lung and other organs were all>0.8.For the delineation of the heart,there was no significant difference between HD and MDA,but MIM was better than the other two.For the delineation of the liver,PVmed and UI were superior to MIM.Although the results of the three types of mapping software were satisfactory in both lungs,their HD values PVmed<MIM<UI were(26.828,28.371,35.004),among which PVmed was superior to UI(P<0.001).There was no significant difference in the delineation of spinal cord by DSC compared with manual delineation(all DSC<0.7,P=0.239),but JC value was all<0.8,and HD value(UI<PVmed<MIM).However,for the small thyroid,the mapping effect was poor,DSC<0.8,JC<0.7,PVmed and MIM were superior to UI,and the three kinds of automatic mapping software HD and MDA had statistical significance(P=0.048,P<0.001),among w

关 键 词：食管癌 放射治疗 自动勾画 危及器官 

分 类 号：R735.1[医药卫生—肿瘤] R730.44[医药卫生—临床医学]