Geometric and Dosimetric Evaluation of Deep Learning-Based Automatic Delineation on CBCT-Synthesized CT and Planning CT for Breast Cancer Adaptive Radiotherapy: A Multi-Institutional Study
机构：[1]Guangzhou Univ Chinese Med, Affiliated Hosp 2, Dept Radiat Therapy, Guangzhou, Peoples R China广东省中医院[2]Southern Med Univ, Sch Biomed Engn, Guangzhou, Peoples R China[3]Guangxi Med Univ, Affiliated Hosp 4, Dept Oncol, Liuzhou, Peoples R China
PurposeWe developed a deep learning model to achieve automatic multitarget delineation on planning CT (pCT) and synthetic CT (sCT) images generated from cone-beam CT (CBCT) images. The geometric and dosimetric impact of the model was evaluated for breast cancer adaptive radiation therapy. MethodsWe retrospectively analyzed 1,127 patients treated with radiotherapy after breast-conserving surgery from two medical institutions. The CBCT images for patient setup acquired utilizing breath-hold guided by optical surface monitoring system were used to generate sCT with a generative adversarial network. Organs at risk (OARs), clinical target volume (CTV), and tumor bed (TB) were delineated automatically with a 3D U-Net model on pCT and sCT images. The geometric accuracy of the model was evaluated with metrics, including Dice similarity coefficient (DSC) and 95% Hausdorff distance (HD95). Dosimetric evaluation was performed by quick dose recalculation on sCT images relying on gamma analysis and dose-volume histogram (DVH) parameters. The relationship between Delta D95, Delta V95 and DSC-CTV was assessed to quantify the clinical impact of the geometric changes of CTV. ResultsThe ranges of DSC and HD95 were 0.73-0.97 and 2.22-9.36 mm for pCT, 0.63-0.95 and 2.30-19.57 mm for sCT from institution A, 0.70-0.97 and 2.10-11.43 mm for pCT from institution B, respectively. The quality of sCT was excellent with an average mean absolute error (MAE) of 71.58 +/- 8.78 HU. The mean gamma pass rate (3%/3 mm criterion) was 91.46 +/- 4.63%. DSC-CTV down to 0.65 accounted for a variation of more than 6% of V95 and 3 Gy of D95. DSC-CTV up to 0.80 accounted for a variation of less than 4% of V95 and 2 Gy of D95. The mean Delta D90/Delta D95 of CTV and TB were less than 2Gy/4Gy, 4Gy/5Gy for all the patients. The cardiac dose difference in left breast cancer cases was larger than that in right breast cancer cases. ConclusionsThe accurate multitarget delineation is achievable on pCT and sCT via deep learning. The results show that dose distribution needs to be considered to evaluate the clinical impact of geometric variations during breast cancer radiotherapy.
基金：
National Natural Science
Foundation of China (81771916) and Guangzhou Science and
Technology Plan (202102010264).
第一作者机构：[1]Guangzhou Univ Chinese Med, Affiliated Hosp 2, Dept Radiat Therapy, Guangzhou, Peoples R China
共同第一作者：
通讯作者：
推荐引用方式(GB/T 7714)：
Dai Zhenhui,Zhang Yiwen,Zhu Lin,et al.Geometric and Dosimetric Evaluation of Deep Learning-Based Automatic Delineation on CBCT-Synthesized CT and Planning CT for Breast Cancer Adaptive Radiotherapy: A Multi-Institutional Study[J].FRONTIERS IN ONCOLOGY.2021,11:doi:10.3389/fonc.2021.725507.
APA：
Dai, Zhenhui,Zhang, Yiwen,Zhu, Lin,Tan, Junwen,Yang, Geng...&Wang, Xuetao.(2021).Geometric and Dosimetric Evaluation of Deep Learning-Based Automatic Delineation on CBCT-Synthesized CT and Planning CT for Breast Cancer Adaptive Radiotherapy: A Multi-Institutional Study.FRONTIERS IN ONCOLOGY,11,
MLA：
Dai, Zhenhui,et al."Geometric and Dosimetric Evaluation of Deep Learning-Based Automatic Delineation on CBCT-Synthesized CT and Planning CT for Breast Cancer Adaptive Radiotherapy: A Multi-Institutional Study".FRONTIERS IN ONCOLOGY 11.(2021)
