摘要
目的对头颈部肿瘤患者进行危及器官(OAR)的手工勾画及自动勾画,比较OAR勾画的体积偏差(ΔV)、相似性指数(DSC)及受照剂量,手工勾画差异性与自动勾画不确定性。方法选取2017年7月至2018年7月于医院进行调强放射治疗的5例头颈部肿瘤患者的计划CT图像,由5名专业组高年资医师手工勾画OAR,同时采用ABAS软件自动勾画OAR,最终比较不同医师同一时间手工勾画、同一医师不同时间手工勾画的OAR及手工勾画、自动勾画与参考标准之间产生的ΔV、DSC及百分剂量差异ΔD的平均标准方差(SD)。结果不同医师同一时间手工勾画的OAR,ΔV和ΔD存在显著差异。手工勾画与自动勾画产生的ΔV和DSC的SD相近,但对小体积OAR勾画时,自动勾画的ΔV的SD小于手工勾画。结论不同勾画者对头颈部肿瘤患者的OAR进行勾画时,OAR的ΔV和ΔD存在明显差异;自动勾画OAR的不确定性与手工勾画的不确定性相当。临床上,医师勾画OAR应特别注意人为之间的差异性,尽可能地减少人为因素的影响,甚至可以考虑应用自动勾画软件代替手工勾画,并在此基础上进行适当的修正,从而更好、更客观地评估放射治疗计划。
Objective Manual and automatic delineation of organ at risk(OAR)of patients with head and neck tumors were conducted and the volume deviation(ΔV),the dice similarity coefficient(DSC)and the radiation dose were compared between the two different delineation means,the difference of manual delineation and the uncertainty of automatic delineation were also compared.Methods The planned CT images of five patients with head and neck tumors who had received intensity modulated radiation therapy in the hospital from July 2017 to July 2018 were selected.The OAR was delineated by five senior physicians in the professional group and meanwhile the OAR was delineated by ABAS software automatically.Finally,theΔV,the DSC and the mean standard deviation(SD)ofΔD of OAR of manual delineation by different physicians at the same time,manual delineation by the same physician at different times,and between manual delineation,automatic delineation and the reference standard were compared,respectively.Results There were significant differences inΔV andΔD of OAR delineated by different physicians at the same time.The SD ofΔV and DSC generated by manual and automatic delineation were similar,but for the SD ofΔV,the latter was smaller for small volume OAR.Conclusions There were significant differences inΔV andΔD of OAR when the OAR of patients with head and neck tumors were delineated by different physicians.The uncertainty of OAR by automatic delineation is comparable to that of manual delineation.In clinic,physicians should pay attention to the differences between personal factors in delineating OAR,so as to reduce the influence of personal factors as much as possible,and even can consider replacing the manual delineation with automatic delineation,and then make appropriate corrections,thus the plans of radiation therapy could be evaluated better and more objectively.
作者
程燕铭
Cheng Yanming(Fujian Medical University Cancer Hospital(Fujian Cancer Hospital),Fuzhou Fujian 350014,China)
出处
《医疗装备》
2022年第11期89-93,共5页
Medical Equipment
关键词
头颈部肿瘤
危及器官
手工勾画
自动勾画
Head and neck tumors
Organs at risk
Manual delineation
Automatic delineation
