Development of intelligent delineation model for clinical target volume of nasopharyngeal carcinoma based on integrated clinical health care system

Rong HE; Chuan CHEN; Mengxia LI; He XIAO; Liangzhi ZHONG; Anmei ZHANG; Benxu TAN; Renzhao TIAN; Mingying GENG

doi:10.16016/j.2097-0927.202110030

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Development of intelligent delineation model for clinical target volume of nasopharyngeal carcinoma based on integrated clinical health care system

Clinical Medicine | 更新时间：2026-01-09

- Development of intelligent delineation model for clinical target volume of nasopharyngeal carcinoma based on integrated clinical health care system
- Journal of Army Medical University Vol. 44, Issue 9, Pages: 906-912(2022)
- 作者机构：
  
  1.400042重庆，陆军特色医学中心肿瘤科
  2.400037 重庆，陆军军医大学(第三军医大学)第二附属医院肿瘤科
  3.400010 重庆，重庆医科大学附属第二医院肿瘤科
  4.401120 重庆，重庆医科大学附属第三医院肿瘤科
- 作者简介：
- 基金信息：
  
  the Special Project of Digital Diagnosis and Treatment Equipment Development of Ministry of Science and Technology(2018YFC0114402)
- DOI：10.16016/j.2097-0927.202110030
  CLC： R319;R730.55;R739.63
- Received：11 October 2021，
  
  Revised：2021-12-10，
  
  Published：15 May 2022
- 稿件说明：
移动端阅览
Rong HE, Chuan CHEN, Mengxia LI, et al. Development of intelligent delineation model for clinical target volume of nasopharyngeal carcinoma based on integrated clinical health care system[J]. Journal of Army Medical University, 2022, 44(9): 906-912.
DOI：

Rong HE, Chuan CHEN, Mengxia LI, et al. Development of intelligent delineation model for clinical target volume of nasopharyngeal carcinoma based on integrated clinical health care system[J]. Journal of Army Medical University, 2022, 44(9): 906-912. DOI： 10.16016/j.2097-0927.202110030.

摘要

目的

利用人工智能(artificial intelligence，AI)技术创建一套鼻咽癌临床靶区(clinical target volume

CTV)勾画模型，即AI+CTV模型，以提高鼻咽癌勾画效率和不同层级放疗单位、不同技术层次放疗医生鼻咽癌CTV勾画的准确性。

方法

选取2020年9月至2021年5月陆军特色医学中心肿瘤科放疗中心收治的分期较早(T1~2N2)且淋巴结较小(≤2 cm)的鼻咽癌患者30例，其中男性20例，女性10例；中位年龄52岁；按2017年鼻咽癌CTV勾画国际指南勾画CTV并进行深度学习，获得AI+CTV模型。利用陆军特色医学中心肿瘤科10例(男性7例，女性3例；中位年龄54岁)及3所教学医院6例(男性4例，女性2例；中位年龄46岁)鼻咽癌手动勾画CTV分别对该模型进行验证，对比分析其相似系数(dice similarity coefficient，DSC)、豪斯多夫距离(hausdorff distance，HD)、对称位置平均表面距离(average symmetric surface distance，ASSD)、最大对称表面距离(maximum symmetric surface distance，MSSD)和相对/绝对体积比(relative absolute volume difference，RAVD)，以评估AI勾画的可行性和准确性。

结果

该AI+CTV模型的准确性较高，平均DSC值为0.865，且内部验证显示高危区(CTV1)和低危区(CTV2)的中位DSC值均较高，分别为0.886和0.842。CTV1和CTV2的中位HD、ASSD、MSSD和RAVD均较低，分别为7.789 mm和6.144 mm、1.683 mm和1.467 mm、20.52 mm和14.03 mm及16.30%和15.14%。6例外部验证结果显示：CTV1勾画一致性高于CTV2。除1例患者的CTV2-DSC值接近0.7外，6例患者CTV1和其余5例患者CTV2勾画一致性较好(DSC值均>0.7)。

结论

基于小样本的AI+CTV模型在分期较早(T1~2N2)且淋巴结较小(≤2 cm)的鼻咽癌患者放疗CTV勾画中的临床应用基本可行。

Abstract

Objective

To established an intelligent delineation model of clinical target volume (CTV) for nasopharyngeal carcinoma (NPC) using artificial intelligence (AI) technology to improve the efficiency and the accuracy of CTV delineation among various radiotherapy institutes and clinicians with different technical levels.

Methods

Thirty NPC patients (20 males and 10 females

at a median age of 52 years) with early stage (T1~2N2) and small lymph nodes (≤ 2 cm) admitted in our Army Medical Center of PLA from September 2020 to May 2021 were collected in this study. CTV was delineated according to the International Guideline of CTV Delineation for NPC in 2017

and a deep learning model was trained to obtain AI+CTV model. The model was subsequently tested with manually segmented CTV in 10 NPC cases (7 males and 3 females

at a median age of 54 years) in our medical center and 6 cases (4 males and 2 females

at a median age of 46 years) from the teaching hospitals. Dice similarity coefficient (DSC)

Hausdorff distance (HD)

average symmetric surface distance (ASSD)

maximum symmetric surface distance (MSSD) and relative absolute volume difference (RAVD) were analyzed to evaluate the feasibility and accuracy of AI delineation.

Results

Our established AI+CTV model obtained quite high accuracy

with an average DSC value of 0.865

and median DSC values of high-risk areas (CTV1) and low-risk areas (CTV2) of 0.886 and 0.842

respectively. The median HD

ASSD

MSSD and RAVD of CTV1 and CTV2 were all quite low

that is

7.789 and 6.144 mm

1.683 and 1.467 mm

20.52 and 14.03 mm

16.30% and 15.14%

respectively. The results of external verification showed that CTV1 delineation had higher consistency than CTV2. CTV1 of 6 patients and CTV2 of 5 patients were well delineated (DSC value was greater than 0.7) except CTV2-DSC value of 1 case was close to 0.7.

Conclusion

Our AI+CTV model based on small samples is basically feasible for the clinical application of CTV delineation in NPC patients with early stage (T1~2N2) and small lymph nodes (≤2 cm).

关键词

Keywords

references

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