Atlas-guided prostate intensity modulated radiation therapy (IMRT) planning.
Atlas-guided prostate intensity modulated radiation therapy (IMRT) planning.
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DOI：
10.1088/0031-9155/60/18/7277
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发表时间：
2015-09-21
影响因子：
3.5
通讯作者：
Wu QJ
中科院分区：
文献类型：
--
作者：
Sheng Y;Li T;Zhang Y;Lee WR;Yin FF;Ge Y;Wu QJ
一个基于图谱的调强放射治疗计划技术的前列腺癌的开发和评估。基于患者的解剖模式，更具体地说，到前列腺的百分比距离（PDP）和精囊相对于前后轴形成的凹面角，建立了多剂量图谱。使用k-中心点聚类分析对70个病例数据集进行分类，以识别数据集中的解剖模式变化。最好的分类，定义的类或medoids的数量，是由最大值的平均轮廓宽度。每个类别的参考计划形成了一个多剂量图谱。图谱引导计划（AGP）技术首先将新病例解剖结构模式与图谱中的一个参考病例进行匹配;然后，图谱与新病例解剖结构之间的可变形配准将剂量从图谱转移到新病例，以全自动引导反向计划。重新计划了另外20例临床病例，以评价AGP技术。评估了AGP和临床计划之间的剂量学特性。分类分析确定5例图谱最能代表患者队列的解剖结构模式。对于所有情况，AGP平均花费约1分钟（对应于70次优化迭代）。当比较剂量学参数时，AGP和临床计划之间的差异小于3.5%，尽管观察到一些统计学显著性：均匀性指数（p > 0.05）、一致性指数（p < 0.01）、膀胱gEUD（p < 0.01）和直肠gEUD（p = 0.02）。经尿道引导的治疗计划是可行和有效的。Atlas预测剂量可以有效地指导优化器实现与临床计划相当的计划质量。
An atlas-based IMRT planning technique for prostate cancer was developed and evaluated. A multi-dose atlas was built based on the anatomy patterns of the patients, more specifically, the Percent Distance to the Prostate (PDP) and the concaveness angle formed by the seminal vesicles relative to the anterior-posterior axis. The 70-case dataset was classified using a k-medoids clustering analysis to recognize anatomy pattern variations in the dataset. The best classification, defined by the number of classes or medoids, was determined by the largest value of the average silhouette width. Reference plans from each class formed a multi-dose atlas. The atlas-guided planning (AGP) technique started with matching the new case anatomy pattern to one of the reference cases in the atlas; then a deformable registration between the atlas and new case anatomies transferred the dose from the atlas to the new case to guide inverse planning with full automation. Additional 20 clinical cases were re-planned to evaluate the AGP technique. Dosimetric properties between AGP and clinical plans were evaluated. The classification analysis determined that the 5-case atlas would best represent anatomy patterns for the patient cohort. AGP took approximately 1 min on average (corresponding to 70 iterations of optimization) for all cases. When dosimetric parameters were compared, the differences between AGP and clinical plans were less than 3.5%, albeit some statistical significances observed: Homogeneity index (p > 0.05), conformity index (p < 0.01), bladder gEUD (p < 0.01), and rectum gEUD (p = 0.02). Atlas-guided treatment planning is feasible and efficient. Atlas predicted dose can effectively guide the optimizer to achieve plan quality comparable to that of clinical plans.