智能一体化技术在直肠癌放疗中的应用：自动化效率与安全性的回顾性研究

Implementation of intelligent All-in-one technology in rectal cancer radiotherapy: A retrospective study on automation efficiency and safety.

作者信息

Zhai Haoyang, Wang Jiazhou, Hu Weigang

机构信息

Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Clinical Research Center for Radiation Oncology, Shanghai Key Laboratory of Radiation Oncology, Shanghai Medical College, Fudan University, Shanghai, China.

出版信息

J Appl Clin Med Phys. 2025 Sep;26(9):e70236. doi: 10.1002/acm2.70236.

DOI:10.1002/acm2.70236

PMID:40926710

Abstract

PURPOSE

This study aims to assess percentage of automated AIO plans that met clinical treatment standards of radiotherapy plans generated by the fully automated All-in-one (AIO) process.

METHODS

The study involved 117 rectal cancer patients who underwent AIO treatment. Fully automated regions of interest (ROI) and treatment plans were developed without manual intervention, comparing them to manually generated plans used in clinical practice. Geometric and dosimetric metrics were collected from both automated and manual plans. The relationship between the geometric and dosimetric metrics of the planning target volume (PTV) was evaluated using Spearman correlation analysis. The interquartile range (IQR) method was applied to determine the percentage of automated plans meeting clinical requirements. Additionally, dosimetric metrics for organs at risk (OAR) were compared between automated and manual plans using paired t-tests. The reasons for dose discrepancies were examined based on target volume.

RESULTS

Spearman correlation analysis showed a moderate correlation between geometric metrics and the conformity index (△CI) in dosimetric metrics. The correlation coefficients were as follows: Hausdorff distance (HD, |ρ| = 0.458, p < 0.01), Mean deviation area (MDA, |ρ| = 0.565, p < 0.01), Dice similarity coefficient (DSC, |ρ| = 0.631, p < 0.01), and Jaccard index (JI, |ρ| = 0.632, p < 0.01). Statistical analysis revealed that the mean doses to the bladder and bilateral femoral heads were significantly lower in automated plans compared to manual ones (p < 0.01). This difference is likely due to variations in ROI delineation between automated and manual methods. The IQR method showed that 81.2% of automated AIO plans met clinical requirements without manual intervention.

CONCLUSION

In routine clinical practice, approximately 81.2% of automated AIO plans met clinical requirements without requiring manual intervention.

摘要

目的

本研究旨在评估通过全自动化一体化（AIO）流程生成的自动AIO计划符合放射治疗计划临床治疗标准的百分比。

方法

该研究纳入了117例行AIO治疗的直肠癌患者。在无人工干预的情况下制定全自动化感兴趣区域（ROI）和治疗计划，并将其与临床实践中使用的手动生成计划进行比较。从自动和手动计划中收集几何和剂量学指标。使用Spearman相关分析评估计划靶体积（PTV）的几何和剂量学指标之间的关系。应用四分位数间距（IQR）方法确定符合临床要求的自动计划的百分比。此外，使用配对t检验比较自动和手动计划中危及器官（OAR）的剂量学指标。根据靶体积检查剂量差异的原因。

结果

Spearman相关分析显示几何指标与剂量学指标中的适形指数（△CI）之间存在中等相关性。相关系数如下：豪斯多夫距离（HD，|ρ| = 0.

458，p < 0.01）、平均偏差面积（MDA，|ρ| = 0.565，p < 0.01）、骰子相似系数（DSC，|ρ| = 0.631，p < 0.01）和杰卡德指数（JI，|ρ| = 0.632，p < 0.01）。统计分析表明，与手动计划相比，自动计划中膀胱和双侧股骨头的平均剂量显著更低（p < 0.01）。这种差异可能是由于自动和手动方法在ROI勾画方面的差异。IQR方法显示，81.2%的自动AIO计划在无人工干预的情况下符合临床要求。