实用医学杂志2024，Vol.40Issue(17)：2406-2411,6.DOI:10.3969/j.issn.1006-5725.2024.17.009
自动勾画技术在全乳内侧瘤床同步推量中的应用
Clinical Application of automatic delineation in whole breast radiotherapy with simultaneous integrated boost to the medial tumor beds
摘要
Abstract
Objective To assess the viability and efficacy of employing automated segmentation for whole breast radiotherapy with simultaneous integrated boost to the medial tumor beds,a comparative analysis was conducted on the disparities in geometry,dosimetry,and working time between the auto-segmentation(AS)and manual segmentation(MS)groups.Methods A total of 30 patients with early breast cancer,who had undergone conserving surgery and received hypofractionated radiotherapy with a boost to the medial tumor bed,were enrolled from the First People's Hospital of Zunyi.AccuContour software was used in the AS group to obtain the whole breast planning target volume and cardiopulmonary structure.Geometric differences between AS and MS groups were assessed using Dice similarity coefficient(DSC)and 95%Hausdorff distance(95HD).Subsequently,a comparison was made between the two groups regarding target and cardiopulmonary dosimetry for PlanA and PlanM.Additionally,the time spent by each group was also compared.Results The DSC of PGTV,PTV,lung,and heart were 0.94(0.91,0.96),0.88(0.86,0.91),0.98(0.97,0.98)and 0.94(0.93,0.95),respectively.And the 95 HD(cm)were 0.25(0.20,0.33),0.99(0.56,1.20),0.29(0.25,0.35)and 0.50(0.50,0.59)respectively.The dosimetric results showed that the V95,D95,and Dmean of PGTV and PTV in the AS group were significantly lower than those in the MS group(P<0.05);while the V20 and MLD of the left lung were significantly higher(P<0.05).No significant difference was observed in cardiac dose between the two groups.The mean absolute differences of PGTV and cardiopulmonary dose parameters between the two groups were less than 1 Gy/1%,respec-tively.In terms of work efficiency,the AS approach substantially reduced contouring and planning time with over 70%of cases approved within two days.Conclusions The differences in geometric and dosimetric parameters between the auto-segmentation and manual segmentation groups were found to be negligible for whole breast radiotherapy with medial tumor bed boost patients.It is recommended that the PTV be manually modified prior to plan optimiza-tion,leading to a significant improvement in work efficiency.关键词
乳腺癌/自动勾画/剂量学/内侧瘤床Key words
breast cancer/auto-segmentation/dosimetry/medial tumor bed分类
医药卫生引用本文复制引用
陈车,罗德红,喻皇飞,张琴,胡小池,余盛华,李亚军..自动勾画技术在全乳内侧瘤床同步推量中的应用[J].实用医学杂志,2024,40(17):2406-2411,6.基金项目
国家自然科学基金项目(编号:82060544) （编号:82060544）
贵州省科技计划项目(编号:黔科合基础-ZK[2023]一般486) （编号:黔科合基础-ZK[2023]一般486）
遵义市科技计划项目[编号:HZ(2020)103] （2020）
