头颈肿瘤调强放疗结构命名标准化的方法与实现
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摘要
目的:实现头颈肿瘤放射治疗结构命名的标准化。方法:收集139例患者的调强放射治疗计划,采用MATLAB软件对结构文件进行编程解析,以靶区、危及器官和其他辅助结构3类为关键词,进行结构的归类统计。按照AAPM TG-263提供的标准化的放射肿瘤结构命名报告,制定结构标准化规则,编程实现结构命名标准化的自动转换。结果:139例患者的DICOM Structure文件中,共有7 044个结构,其中靶区2 217个(大体肿瘤靶区510个、临床靶区431个、计划靶区1 276个)、危及器官4 069个、辅助结构758个,平均每位患者有(50.68±15.43)个结构。通过自编程软件找出差异并成功标准化转换,并生成新的结构文件。结论:标准化命名可以避免由命名的不一致或不适当而导致的混淆,防范剂量统计分析时的错误,进而提高医疗质量与安全。
Objective To standardize naming conventions in intensity-modulated radiotherapy(IMRT) of head and neck tumors.Methods The radiotherapy plans of 139 patients with head and neck tumors were randomly selected in the study, and the structure files were parsed and analyzed by self-programmed MATLAB software. All the structures were classified by the keywords which included target areas, organs-at-risk, derivative and planning structure. According to the protocol on the standardization of nomenclature for radiotherapy in AAPM TG 263(The American Association of Physicists in Medicine Task Group 263), the standardization rules for structure naming were established, and the automatic naming convention was implemented by the selfprogrammed software. Results In the DICOM Structure files of 139 patients, there were 7 044 structures in total, including 2 217 target structures(510 GTV, 431 CTV and 1 276 PTV), 4 069 organs-at-risk and 758 derivative and planning structures. The average number of structures for each patient was 50.68±15.43. The differences of structure nomenclatures were detected and successfully standardized through the self-programmed software. Conclusion The standardization of structure nomenclatures in radiotherapy of head and neck tumors prevents the confusion from inconsistency and inadequacy of nomenclatures, and avoids the errors in dosimetric calculations, thereby improving the quality and safety of radiotherapy.
Objective To standardize naming conventions in intensity-modulated radiotherapy(IMRT) of head and neck tumors.Methods The radiotherapy plans of 139 patients with head and neck tumors were randomly selected in the study, and the structure files were parsed and analyzed by self-programmed MATLAB software. All the structures were classified by the keywords which included target areas, organs-at-risk, derivative and planning structure. According to the protocol on the standardization of nomenclature for radiotherapy in AAPM TG 263(The American Association of Physicists in Medicine Task Group 263), the standardization rules for structure naming were established, and the automatic naming convention was implemented by the selfprogrammed software. Results In the DICOM Structure files of 139 patients, there were 7 044 structures in total, including 2 217 target structures(510 GTV, 431 CTV and 1 276 PTV), 4 069 organs-at-risk and 758 derivative and planning structures. The average number of structures for each patient was 50.68±15.43. The differences of structure nomenclatures were detected and successfully standardized through the self-programmed software. Conclusion The standardization of structure nomenclatures in radiotherapy of head and neck tumors prevents the confusion from inconsistency and inadequacy of nomenclatures, and avoids the errors in dosimetric calculations, thereby improving the quality and safety of radiotherapy.
引文
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[9]谭淑慧,李玉锋,黄浦,等.头颈部肿瘤ART-IMRT四种方案剂量学评估[J].中华放射肿瘤学杂志, 2017, 26(5):560-564.TAN S H, LI Y F, HUANG P, et al. Dosimetric evaluation of fouradaptive IMRT strategies for head-neck cancer[J]. Chinese Journalof Radiation Oncology, 2017, 26(5):560-564.
[10]倪晓晨,王胜资,李骥,等.鼻咽癌调强放疗中限制剂量与提高保护权重对听觉器官剂量分布影响的研究[J].中华放射肿瘤学杂志,2013, 22(6):478-481.NI X C, WANG S Z, LI J, et al. Effects of dose limitation andincreased protective weight on dose distribution in auditory organsduring intensity-modulated radiotherapy for nasopharyngealcarcinoma[J]. Chinese Journal of Radiation Oncology, 2013, 22(6):478-481.
[11]庞皓文,孙小杨,杨波,等. IMRT中OAR和靶区相交体积与其吸收剂量间关系研究[J].中华放射肿瘤学杂志, 2017, 26(2):187-191.PANG H W, SUN X Y, YANG B, et al. Relationship between theoverlap volume of organ at risk and target and the dose to organ atrisk in intensity-modulated radiotherapy[J]. Chinese Journal ofRadiation Oncology, 2017, 26(2):187-191.
[12]MAYO C S, PHILLIPS M, MCNUTT T R, et al. Treatment data andtechnical process challenges for practical big data efforts in radiationoncology[J]. Med Phys, 2018, 45(10):e793-e810.
[13]SCHULER T, KIPRITIDIS J, EADE T, et al. Big data readiness inradiation oncology:an efficient approach for relabeling radiationtherapy structures with their TG-263 standard name in real-world datasets[J]. Adv Radiat Oncol, 2018. DOI:10.1016/j.adro.2018.09.013.
[14]何滋鱼,葛云. DICOM格式放疗计划信息的读取及显示[J].中国医学物理学杂志, 2013, 30(4):4299-4302.HE Z Y, GE Y. Read and display DICOM format radiotherapy planninginformation[J]. Chinese Journal of Medical Physics, 2013, 30(4):4299-4302.
[15]周志尊,崔豹,丁晶,等.活体器官不规则体积计算方法的研究[J].中国医学物理学杂志, 2011, 28(4):2754-2758.ZHOU Z Z, CUI B, DING J, et al. The research of human living organirregular volume calculation method[J]. Chinese Journal of MedicalPhysics, 2011, 28(4):2754-2758.
[16]叶志前,周庆利,谢英杰,等. DICOM放射治疗协议(RT)的研究应用[J].中华放射医学与防护杂志, 2004, 24(3):258-260.YE Z Q, ZHOU Q L, XIE Y J, et al. Research and application ofDICOM radiotherapy protocol(RT)[J]. Chinese Journal ofRadiological Medicine and Protection, 2004, 24(3):258-260.
[17]蒲立新,曲建明. DICOM放射治疗中结构集文件的创建[J].中国数字医学, 2011, 6(2):102-105.PU L X, QU J M. The ctreation of radiothreay structure set files inDICOM[J]. China Digital Medicine, 2011, 6(2):102-105.
[18]高忠军. DICOM放射治疗中结构集文件的生成和放疗信息的封装[D].成都:电子科技大学, 2013.GAO Z J. Dicom radiotherapy structure set file generation andradiation therapy information of the package[D]. Chengdu:University of Electronic Science and Technology of China, 2013.
[19]王烝. DICOM协议在肿瘤放射治疗中的应用[J].中国辐射卫生,2006, 15(2):237-238.WANG Z. Application of DICOM protocol in cancer radiotherapy[J].Chinese Journal of Radiological Health, 2006, 15(2):237-238.
[20]何滋鱼,周宇,朱振国,等.基于Open GL ES的移动端DICOM图像三维重建技术[J].中国医学物理学杂志, 2017, 34(10):1018-1021.HE Z Y, ZHOU Y, ZHU Z G, et al. OpenGL ES-based three-dimensional reconstruction of DICOM image on mobile device[J]. Chinese Journal of Medical Physics, 2017, 34(10):1018-1021.
[21]周旺.基于自设计图像处理技术实现放射治疗文件的读取和显示[J].中国医学装备, 2016, 13(6):5-8.ZHOU W. Reading and displaying DICOM RT structure based onMatlab[J]. China Medical Equipment, 2016, 13(6):5-8.
[2] MEISSNER W A. What's in a name?—The standardization of tumornomenclature[J]. Int J Radiat Oncol Biol Phys, 1976, 1(11):1245-1246.
[3] MAYO C, MORAN J M, XIAO Y, et al. AAPM task group 263:tackling standardization of nomenclature for radiation therapy[J]. IntJ Radiat Oncol Biol Phys, 2015, 93(3):E383-E384.
[4] SANTANAM L, HURKMANS C, MUTIC S, et al. Standardizingnaming conventions in radiation oncology[J]. Int J Radiat Oncol BiolPhys, 2012, 83(4):1344-1349.
[5] SIOCHI R A, BALTER P, BLOCH C D, et al. Information technologyresource management in radiation oncology[J]. J Appl Clin Med Phys,2009, 10(4):16-35.
[6] MATUSZAK M, MORAN J, XIAO Y, et al. SU-E-P-22:AAPM taskgroup 263 tackling standardization of nomenclature for radiationtherapy[J]. Med Phys, 2015, 42(6 Part 4):3231.
[7] MAYO C S, MORAN J M, BOSCH W R, et al. Report no.263-standarizing nomenclatures in radiation oncology[R]. 2018. https://www.aapm.org/pubs/reports/detail.asp?docid=171.
[8] MAYO C S, MORAN J M, BOSCH W R, et al. American associationof physicists in medicine task group 263:standardizing nomenclaturesin radiation oncology[J]. Int J Radiat Oncol Biol Phys, 2018, 100(4):1057-1066.
[9]谭淑慧,李玉锋,黄浦,等.头颈部肿瘤ART-IMRT四种方案剂量学评估[J].中华放射肿瘤学杂志, 2017, 26(5):560-564.TAN S H, LI Y F, HUANG P, et al. Dosimetric evaluation of fouradaptive IMRT strategies for head-neck cancer[J]. Chinese Journalof Radiation Oncology, 2017, 26(5):560-564.
[10]倪晓晨,王胜资,李骥,等.鼻咽癌调强放疗中限制剂量与提高保护权重对听觉器官剂量分布影响的研究[J].中华放射肿瘤学杂志,2013, 22(6):478-481.NI X C, WANG S Z, LI J, et al. Effects of dose limitation andincreased protective weight on dose distribution in auditory organsduring intensity-modulated radiotherapy for nasopharyngealcarcinoma[J]. Chinese Journal of Radiation Oncology, 2013, 22(6):478-481.
[11]庞皓文,孙小杨,杨波,等. IMRT中OAR和靶区相交体积与其吸收剂量间关系研究[J].中华放射肿瘤学杂志, 2017, 26(2):187-191.PANG H W, SUN X Y, YANG B, et al. Relationship between theoverlap volume of organ at risk and target and the dose to organ atrisk in intensity-modulated radiotherapy[J]. Chinese Journal ofRadiation Oncology, 2017, 26(2):187-191.
[12]MAYO C S, PHILLIPS M, MCNUTT T R, et al. Treatment data andtechnical process challenges for practical big data efforts in radiationoncology[J]. Med Phys, 2018, 45(10):e793-e810.
[13]SCHULER T, KIPRITIDIS J, EADE T, et al. Big data readiness inradiation oncology:an efficient approach for relabeling radiationtherapy structures with their TG-263 standard name in real-world datasets[J]. Adv Radiat Oncol, 2018. DOI:10.1016/j.adro.2018.09.013.
[14]何滋鱼,葛云. DICOM格式放疗计划信息的读取及显示[J].中国医学物理学杂志, 2013, 30(4):4299-4302.HE Z Y, GE Y. Read and display DICOM format radiotherapy planninginformation[J]. Chinese Journal of Medical Physics, 2013, 30(4):4299-4302.
[15]周志尊,崔豹,丁晶,等.活体器官不规则体积计算方法的研究[J].中国医学物理学杂志, 2011, 28(4):2754-2758.ZHOU Z Z, CUI B, DING J, et al. The research of human living organirregular volume calculation method[J]. Chinese Journal of MedicalPhysics, 2011, 28(4):2754-2758.
[16]叶志前,周庆利,谢英杰,等. DICOM放射治疗协议(RT)的研究应用[J].中华放射医学与防护杂志, 2004, 24(3):258-260.YE Z Q, ZHOU Q L, XIE Y J, et al. Research and application ofDICOM radiotherapy protocol(RT)[J]. Chinese Journal ofRadiological Medicine and Protection, 2004, 24(3):258-260.
[17]蒲立新,曲建明. DICOM放射治疗中结构集文件的创建[J].中国数字医学, 2011, 6(2):102-105.PU L X, QU J M. The ctreation of radiothreay structure set files inDICOM[J]. China Digital Medicine, 2011, 6(2):102-105.
[18]高忠军. DICOM放射治疗中结构集文件的生成和放疗信息的封装[D].成都:电子科技大学, 2013.GAO Z J. Dicom radiotherapy structure set file generation andradiation therapy information of the package[D]. Chengdu:University of Electronic Science and Technology of China, 2013.
[19]王烝. DICOM协议在肿瘤放射治疗中的应用[J].中国辐射卫生,2006, 15(2):237-238.WANG Z. Application of DICOM protocol in cancer radiotherapy[J].Chinese Journal of Radiological Health, 2006, 15(2):237-238.
[20]何滋鱼,周宇,朱振国,等.基于Open GL ES的移动端DICOM图像三维重建技术[J].中国医学物理学杂志, 2017, 34(10):1018-1021.HE Z Y, ZHOU Y, ZHU Z G, et al. OpenGL ES-based three-dimensional reconstruction of DICOM image on mobile device[J]. Chinese Journal of Medical Physics, 2017, 34(10):1018-1021.
[21]周旺.基于自设计图像处理技术实现放射治疗文件的读取和显示[J].中国医学装备, 2016, 13(6):5-8.ZHOU W. Reading and displaying DICOM RT structure based onMatlab[J]. China Medical Equipment, 2016, 13(6):5-8.