自动勾画技术在全乳内侧瘤床同步推量中的应用

doi:10.3969/j.issn.1006-5725.2024.17.009

Abstract

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%， respectively. 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 optimization， leading to a significant improvement in work efficiency.

Key words: breast cancer, auto-segmentation, dosimetry, medial tumor bed

CLC Number:

R737.9

Che CHEN,Dehong LUO,Huangfei YU,Qin ZHANG,Xiaochi HU,Shenghua YU,Yajun. LI. Clinical Application of automatic delineation in whole breast radiotherapy with simultaneous integrated boost to the medial tumor beds[J]. The Journal of Practical Medicine, 2024, 40(17): 2406-2411.

Figures/Tables 5

Fig.1

Tab.1

Fig.2

Tab.2

Fig.3

References 27

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结构	勾画体积		t值	P值
结构	自动勾画	人工勾画	t值	P值
靶区
PGTV	61.09 ± 31.03	58.23 ± 31.95	4.73	< 0.001
PTV	673.32 ± 186.36	643.69 ± 191.57	3.72	0.001
危及器官
左肺	1 100.51 ± 190.51	1 106.79 ± 186.01	-2.46	0.02
心脏	543.35 ± 76.95	569.21 ± 78.45	-5.58	< 0.001

结构	剂量参数	自动勾画	人工勾画	绝对差异（△）	t值	P值
靶区
PGTV	V₉₅（%）	99.27 ± 0.52	99.79 ± 0.27	0.55 ± 0.41^*	-6.31	< 0.001
	D₉₅(Gy)	48.23 ± 0.71	48.65 ± 0.47	0.56 ± 0.39^*	-4.19	< 0.001
	D_mean(Gy)	50.05 ± 0.23	50.12 ± 0.29	0.20 ± 0.19^*	-1.39	0.18
PTV	V₉₅（%）	96.77 ± 2.29	99.40 ± 0.45	2.64 ± 2.13	-6.75	< 0.001
	D₉₅(Gy)	39.48 ± 2.35	41.43 ± 0.48	2.12 ± 2.02	-4.88	< 0.001
	D_mean(Gy）	43.83 ± 0.68	44.36 ± 0.44	0.56 ± 0.40	-5.95	< 0.001
危及器官
左肺	V₅（%）	46.09 ± 4.41	46.28 ± 4.46	0.19 ± 2.29	-0.31	0.76
	V₂₀（%）	19.18 ± 1.59	18.39 ± 1.76	0.98 ± 1.09	3.48	0.02
	MLD(Gy)	10.22 ± 0.79	9.87 ± 0.79	0.48 ± 0.50*	3.19	0.03
心脏	V₈（%）	18.31 ± 2.28	18.61 ± 2.35	0.30 ± 2.58	-0.74	0.47
	V₃₀（%）	4.67 ± 1.94	4.64 ± 2.03	0.03 ± 1.40	0.15	0.89
	MHD(Gy)	5.41 ± 0.82	5.49 ± 0.85	0.08 ± 0.69*	-0.79	0.44

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Clinical Application of automatic delineation in whole breast radiotherapy with simultaneous integrated boost to the medial tumor beds

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