Dinç Serap Çatlı, Üçgül Aybala Nur, Bora Hüseyin, Şentürk Ertuğrul
Department of Radiation Oncology, Faculty of Medicine School of Gazi University, Ankara, Turkey.
Department of Radiation Oncology, Gulhane Training and Research Hospital, Ankara, Turkey.
BMC Urol. 2025 Aug 2;25(1):190. doi: 10.1186/s12894-025-01875-8.
In study, we aimed to dosimetrically evaluate the usability of a new generation autocontouring algorithm (DirectORGANS) that automatically identifies organs and contours them directly in the computed tomography (CT) simulator before creating prostate radiotherapy plans.
The CT images of 10 patients were used in this study. The prostates, bladder, rectum, and femoral heads of 10 patients were automatically contoured based on DirectORGANS algorithm at the CT simulator. On the same CT image sets, the same target volumes and contours of organs at risk were manually contoured by an experienced physician using MRI images and used as a reference structure. The doses of manually delineated contours of the target volume and organs at risk and the doses of auto contours of the target volume and organs at risk were obtained from the dose volume histogram of the same plan. Conformity index (CI) and homogeneity index (HI) were calculated to evaluate the target volumes. In critical organ structures, V V V for the rectum, V V70, V75, and V for the bladder, and maximum doses for femoral heads were evaluated. The Mann-Whitney U test was used for statistical comparison with statistical package SPSS (P < 0.05).
Compared to the doses of the manual contours (MC) with auto contours (AC), there was no significant difference between the doses of the organs at risk. However, there were statistically significant differences between HI and CI values due to differences in prostate contouring (P < 0.05).
The study showed that the need for clinicians to edit target volumes using MRI before treatment planning. However, it demonstrated that delineating organs at risk was used safely without the need for correction. DirectORGANS algorithm is suitable for use in RT planning to minimize differences between physicians and shorten the duration of this contouring step.
在本研究中，我们旨在通过剂量学评估一种新一代自动轮廓勾画算法（DirectORGANS）的可用性，该算法可在创建前列腺放射治疗计划之前，在计算机断层扫描（CT）模拟器中直接自动识别器官并勾画其轮廓。
本研究使用了10名患者的CT图像。在CT模拟器上，基于DirectORGANS算法自动勾画了10名患者的前列腺、膀胱、直肠和股骨头。在相同的CT图像集上，由一名经验丰富的医生使用MRI图像手动勾画相同的靶区体积和危及器官的轮廓，并将其用作参考结构。从同一计划的剂量体积直方图中获取靶区体积和危及器官的手动勾画轮廓的剂量以及自动勾画轮廓的剂量。计算适形指数（CI）和均匀性指数（HI）以评估靶区体积。在关键器官结构中，评估直肠的V 、V70、V75以及膀胱的V ，以及股骨头的最大剂量。使用Mann-Whitney U检验与统计软件包SPSS进行统计学比较（P < 0.05）。
与自动轮廓（AC）的手动轮廓（MC）剂量相比，危及器官的剂量之间无显著差异。然而，由于前列腺轮廓勾画的差异，HI和CI值之间存在统计学显著差异（P < 0.05）。
该研究表明，临床医生在治疗计划前需要使用MRI编辑靶区体积。然而，研究表明在无需校正的情况下可安全地勾画危及器官。DirectORGANS算法适用于放疗计划，以尽量减少医生之间的差异并缩短此轮廓勾画步骤的持续时间。
