Myronakis Marios, Stratakis John, Damilakis John
Department of Medical Physics, School of Medicine, University of Crete, Iraklion, Greece.
Medical Physics Department, University Hospital of Crete, Iraklion, Greece.
Med Phys. 2023 Nov;50(11):7236-7244. doi: 10.1002/mp.16356. Epub 2023 Mar 23.
Patient-specific organ-dose estimation in diagnostic CT examinations can provide useful insights on individualized secondary cancer risks, protocol optimization, and patient management. Current dose estimation techniques mainly rely on time-consuming Monte Carlo methods or/and generalized anthropomorphic phantoms.
We proposed a proof-of-concept rapid workflow based on deep learning networks to estimate organ doses for individuals following thorax Computed Tomography (CT) examinations.
CT scan data from 95 individuals undergoing thorax CT examinations were used. Monte Carlo simulations were performed and three-dimensional (3D) dose distributions for each patient were obtained. A fully connected sequential deep learning network model was constructed and trained for each organ considered in this study. Water-equivalent diameter (WED), scan length, and tube current were the independent variables. Organ doses for heart, lungs, esophagus, and bones were calculated from the Monte Carlo 3D distribution and used to train the deep learning networks. Organ dose predictions from each network were evaluated using an independent data set of 19 patients.
The trained networks provided organ dose predictions within a second. There was very good agreement between the deep learning network predictions and reference organ dose values calculated from Monte Carlo simulations. The average difference was -1.5% for heart, -1.6% for esophagus, -1.0% for lungs, and -0.4% for bones in the 95 patients dataset, and -5.1%, 4.3%, 0.9%, and 1.4% respectively in the 19 patients test dataset.
The proposed workflow demonstrated that patient-specific organ-doses can be estimated in nearly real-time using deep learning networks. The workflow can be readily implemented and requires a small set of representative data for training.
在诊断性CT检查中,针对患者个体的器官剂量估计可为个体化的继发性癌症风险、方案优化及患者管理提供有用的见解。当前的剂量估计技术主要依赖耗时的蒙特卡罗方法或/和通用的人体模型。
我们提出了一种基于深度学习网络的概念验证快速工作流程,用于估计胸部计算机断层扫描(CT)检查后个体的器官剂量。
使用了95名接受胸部CT检查的个体的CT扫描数据。进行了蒙特卡罗模拟,并获得了每位患者的三维(3D)剂量分布。针对本研究中考虑的每个器官构建并训练了一个全连接顺序深度学习网络模型。水等效直径(WED)、扫描长度和管电流为自变量。从蒙特卡罗3D分布计算心脏、肺、食管和骨骼的器官剂量,并用于训练深度学习网络。使用19名患者的独立数据集评估每个网络的器官剂量预测。
经过训练的网络在一秒内即可提供器官剂量预测。深度学习网络预测与通过蒙特卡罗模拟计算的参考器官剂量值之间具有非常好的一致性。在95名患者的数据集中,心脏的平均差异为-1.5%,食管为-1.6%,肺为-1.0%,骨骼为-0.4%;在19名患者的测试数据集中,分别为-5.1%、4.3%、0.9%和1.4%。
所提出的工作流程表明,使用深度学习网络可以近乎实时地估计针对患者个体的器官剂量。该工作流程易于实施,并且只需要一小部分代表性数据进行训练。