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体内心肺生物力学建模在外照射放疗中用于有效肿瘤运动跟踪。

In-vivo lung biomechanical modeling for effective tumor motion tracking in external beam radiation therapy.

机构信息

School of Biomedical Engineering, Western University, London, ON, Canada.

Department of Radiation Oncology, London Regional Cancer Program, London, ON, Canada; Department of Oncology, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada; Department of Medical Biophysics, Western University, London, ON, Canada.

出版信息

Comput Biol Med. 2021 Mar;130:104231. doi: 10.1016/j.compbiomed.2021.104231. Epub 2021 Jan 20.

Abstract

Lung cancer is the most common cause of cancer-related death in both men and women. Radiation therapy is widely used for lung cancer treatment; however, respiratory motion presents challenges that can compromise the accuracy and/or effectiveness of radiation treatment. Respiratory motion compensation using biomechanical modeling is a common approach used to address this challenge. This study focuses on the development and validation of a lung biomechanical model that can accurately estimate the motion and deformation of lung tumor. Towards this goal, treatment planning 4D-CT images of lung cancer patients were processed to develop patient-specific finite element (FE) models of the lung to predict the patients' tumor motion/deformation. The tumor motion/deformation was modeled for a full respiration cycle, as captured by the 4D-CT scans. Parameters driving the lung and tumor deformation model were found through an inverse problem formulation. The CT datasets pertaining to the inhalation phases of respiration were used for validating the model's accuracy. The volumetric Dice similarity coefficient between the actual and simulated gross tumor volumes (GTVs) of the patients calculated across respiration phases was found to range between 0.80 ± 0.03 and 0.92 ± 0.01. The average error in estimating tumor's center of mass calculated across respiration phases ranged between 0.50 ± 0.10 (mm) and 1.04 ± 0.57 (mm), indicating a reasonably good accuracy of the proposed model. The proposed model demonstrates favorable accuracy for estimating the lung tumor motion/deformation, and therefore can potentially be used in radiation therapy applications for respiratory motion compensation.

摘要

肺癌是男性和女性癌症相关死亡的最常见原因。放射治疗广泛用于肺癌治疗;然而,呼吸运动带来了挑战,可能会影响放射治疗的准确性和/或效果。使用生物力学建模进行呼吸运动补偿是一种常见的方法,用于解决这一挑战。本研究专注于开发和验证一种能够准确估计肺肿瘤运动和变形的肺生物力学模型。为此,对肺癌患者的治疗计划 4D-CT 图像进行了处理,以开发出用于预测患者肿瘤运动/变形的患者特定有限元 (FE) 模型。肿瘤运动/变形是根据 4D-CT 扫描所捕捉的整个呼吸周期进行建模的。通过反问题公式确定驱动肺和肿瘤变形模型的参数。使用与呼吸吸入阶段相关的 CT 数据集来验证模型的准确性。在呼吸阶段计算的患者实际和模拟的大体肿瘤体积 (GTV) 之间的体积 Dice 相似系数范围在 0.80±0.03 到 0.92±0.01 之间。在呼吸阶段计算的肿瘤质心估计的平均误差范围在 0.50±0.10(mm)到 1.04±0.57(mm)之间,表明该模型具有相当高的准确性。该模型在估计肺肿瘤运动/变形方面具有良好的准确性,因此可能会在放射治疗应用中用于呼吸运动补偿。

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