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Objective@#To compare the accuracy of two automatic segmentation softwares (Smart Segmentation and MIM Atlas) in organs at risk (OARs) contouring for nasopharyngeal carcinoma (NPC).@*Methods@#Totally 55 NPC patients were retrospectively reviewed with manually contoured OARs on CT images, in which 30 cases were randomly selected to create a data base in the Smart Segmentation and MIM Atlas. The remaining 25 cases were automatically contoured with Smart Segmentation and MIM as test cases. The automatic contouring accuracies of two softwares were evaluated with Dice coefficient(DSC), Hausdorff distance(HD), and absolute volume difference(△V) using manual contours as a golden standard.@*Results@#The overall DSC, HD and △V of all organs contoured by MIM Atlas and Smart Segmentation were (0.79±0.13) vs. (0.62±0.24) (t=14.06, P<0.05), (5.50±3.84)mm vs.(8.38±4.88)mm (t=-11.40, P<0.05), and (1.52±2.46) cm3 vs. (2.38±3.57) cm3 (t=-4.70, P<0.05), respectively. The average DSC of 11 organs (brain stem, optic chiasm, bilateral lens, bilateral optic nerve, bilateral eyeballs, bilateral parotid gland, spinal cord) delineated by MIM Atlas was statistically greater than that of Smart Segmentation (t=5.27, 4.41, 6.34, 5.70, 10.62, 7.45, 3.96, 4.26, 6.25, 5.42, 7.23, P<0.05). The average HD of 10 organs (brain stem, optic chiasm, bilateral lens, bilateral optic nerve, bilateral eyeballs, left parotid gland, spinal cord) delineated by MIM Atlas was statistically less than that of Smart Segmentation (t=-4.51, -4.49, -3.92, -3.45, -5.36, -5.56, -3.89, -3.90, -3.60, -3.68, P<0.05). The average △V of 6 organs (brain stem, optic chiasm, left len, bilateral optic nerve, right eyeball) delineated by MIM Atlas was statistically less than that of Smart Segmentation (t=-2.83, -3.39, -2.56, -2.27, -2.43, -2.51, P<0.05).@*Conclusions@#Both softwares have reasonable contouring accuracy for larger organs. The accuracy decreased with the decrease of organ volumes and blurred boundary. Generally, MIM Atlas′s performs better than Smart Segmentation does.
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Objective To compare the accuracy of two automatic segmentation softwares ( Smart Segmentation and MIM Atlas) in organs at risk ( OARs) contouring for nasopharyngeal carcinoma ( NPC) . Methods Totally 55 NPC patients were retrospectively reviewed with manually contoured OARs on CT images, in which 30 cases were randomly selected to create a data base in the Smart Segmentation and MIM Atlas. The remaining 25 cases were automatically contoured with Smart Segmentation and MIM as test cases. The automatic contouring accuracies of two softwares were evaluated with Dice coefficient( DSC) , Hausdorff distance( HD) , and absolute volume difference(△V) using manual contours as a golden standard. Results The overall DSC, HD and △V of all organs contoured by MIM Atlas and Smart Segmentation were (0.79±0.13) vs. (0.62±0.24) (t= 14.06, P<0.05),(5.50±3.84)mm vs.(8.38±4.88)mm ( t=-11. 40, P<0. 05 ) , and ( 1. 52 ± 2. 46 ) cm3 vs. ( 2. 38 ± 3. 57 ) cm3 ( t = -4. 70, P<0. 05 ) , respectively. The average DSC of 11 organs ( brain stem, optic chiasm, bilateral lens, bilateral optic nerve, bilateral eyeballs, bilateral parotid gland, spinal cord) delineated by MIM Atlas was statistically greater than that of Smart Segmentation ( t=5. 27, 4. 41, 6. 34, 5. 70, 10. 62, 7. 45, 3. 96, 4. 26, 6. 25, 5. 42, 7. 23, P<0. 05) . The average HD of 10 organs ( brain stem, optic chiasm, bilateral lens, bilateral optic nerve, bilateral eyeballs, left parotid gland, spinal cord) delineated by MIM Atlas was statistically less than that of Smart Segmentation ( t=-4. 51, -4. 49, -3. 92, -3. 45, -5. 36, -5. 56, -3. 89, -3. 90,-3. 60, -3. 68, P<0. 05). The average △V of 6 organs (brain stem, optic chiasm, left len, bilateral optic nerve, right eyeball) delineated by MIM Atlas was statistically less than that of Smart Segmentation ( t=-2. 83, -3. 39, -2. 56, -2. 27, -2. 43, -2. 51, P<0. 05 ) . Conclusions Both softwares have reasonable contouring accuracy for larger organs. The accuracy decreased with the decrease of organ volumes and blurred boundary. Generally, MIM Atlas's performs better than Smart Segmentation does.
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Objective To compare the dose distribution and setup error of angled breast board position ( ABB) with plain breast board position ( PBB) in breast cancer radiotherapy. Methods Twenty consecutive postoperative left breast cancer patients in the First Affiliated Hospital, Zhejiang University were enrolled from March 2017 to January 2018. All cases were assigned into the ABB and PBB groups according to positions and there were 10 cases in each groups respectively. The target volume, heart and lung structures were defined on the CT images of the localized scan. The plan was designed using the field in field ( FIF) technique to compare the dosimetric parameters of the PTV, lung, and heart treatments, and the setup errors for the two different positions. Results The ipsilateral lung V20[ABB:(11.2 ±3.2)％, PBB:(15.9 ±5.3)％, t= -2.47,P< 0.05], and V30[ABB:(9.8 ±1.5)％, PBB:(12.9 ±2.2)％, t= -4.46,P<0.05] were both statistically significant for the two different position and immobilization. Heart dose V25[ABB: (1.9 ± 0.2)％, PBB: (2.8 ± 0.4)％, t = -8.28, P <0.05], V30 [ABB:(1.8 ±0.1)％, PBB: (2.7 ± 0.3)％, t = -8.34,P < 0.05], and Dmean of heart [ABB: (3.0 ±0.5)Gy, PBB:(5.3 ± 1.2)Gy, t=5.58,P<0.05] were all statistically significant for the two different positions. The translational errors of ABB and PBB on LR, SI, and AP were ( 3.23 ± 2.63 ) , ( 5.42 ± 3.22), (4.58 ± 2.30) mm, and (2.35 ± 1.22), (2.17 ± 1.29), (2.27 ± 1.58) mm, respectively. The rotation errors of pitch(θ), yaw(Φ) and roll(ψ) for ABB and PBB were (1.60 ± 0.56)°, (3.40 ± 1.65)°, (2.50 ± 1.72)°, and (1.37 ± 0.43)°, (1.79 ± 0.71)°, (2.06 ± 0.63)°, respectively. Meanwhile, the in-and out-SI, anterior and posterior AP, yaw rotation error (Φ) were also statistically significant(t=3.06, 2.80, 3.33,P<0.05). Conclusions There is no statistically significant difference in the tumor target between the two position and immobilization techniques. However, the ABB is better than the PBB in normal tissue sparing while the setup accuracy of PBB is better than the ABB.
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Objective To investigate the dosimetric differences among three types of breath hold mode ( free breath:FB, thoracic deep inspiration breath hold: T-DIBH, abdomen deep inspiration breath hold:A-DIBH) and to explore the optimal breath hold method in the postoperative radiotherapy of left-side breast cancer patients with minimum dose to normal tissues and organs at risk. Methods A total of eighteen patients with left-side breast cancer patients who underwent postoperative radiotherapy were enrolled in this study. Three CT simulation scans with three different breath hold method ( FB, T-DIBH, and A-DIBH ) were performed for each patient. Dosimetric differences were compared among plans generated on these three different CT image sets. Results There was no significant difference in the volume, mean dose, and homogeneity of planning target volume ( PTV) among plans generated from three different image sets (P>0. 05). The mean heart dose, mean LAD dose and mean ipsilateral lung dose in plans generated from CT image sets with FB, T-DIBH and A-DIBH were (3. 21 ± 1. 02), (1. 74 ± 0. 51), (1. 31 ±0. 41) Gy (W =171, P <0. 05), (34. 61 ± 13. 51), (14. 38 ±10. 20), (9. 21 ± 6. 53) Gy (W=171, P<0. 05), and (8. 31 ±2. 75), (7. 46 ±1. 96), (6. 89 ±1. 79) Gy (W=171, P<0. 05), respectively. Conclusions Compared with plans with FB, plans with DIBH ( T-DIBH and A-DIBH ) achieved lower cardiac, LAD and pulmonary doses. A-DIBH achieved a better normal dose reduction than T-DIBH.
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Objective To compare the dosimetric results of postoperative intensity modulated radiation therapy (IMRT) using single-energy or mixed-energy photons in invasive thymoma patients.Methods Simulation CT images were acquired and clinical target volume (CTV),planning target volume (PTV) and organs at risk (OARs) were defined.Three sets of fixed-field IMRT planning were generated using 6 MV,10 MV and mixed 6/10 MV photons for each case.Monitor Units (MUs) for each plan were recorded after optimization,and parameters of PTV such as conformity index (CI),homogeneity index (HI) and dose to OARs were evaluated on dose-volume histograms.Results Near-Maximal dose (D2％) received by PTV was better in mixed-energy IMRT as compared with 6 MV(t =3.107,P ＜0.05).HI was better in mixed-energy than in 6 MV(t =2.924,P ＜0.05).There were statistically significant differences in CI among three IMRT plans.MU was higher in 6 MV than in both 10 MV and mixed-energy IMRT.The percentages of lung volumes receiving 5 Gy (V5),10 Gy(V10),20 Gy (V20),30 Gy (V30) and the mean lung dose (D) were also significantly different in most plans.V30 and V40 of the heart were comparable between 6 MV and mixed energy plans but better than in 10 MV plan.Conclusions If the reasonable choice of beam angles and number,and capability of energy selection according to beam directions,with combined advantages of low and high energy photons,mixed IMRT plans can improve the quality of IMRT plans in general and has clinical potential for postoperative radiotherapy of invasive thymomas.
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To determine the serum levels of eotaxin, IL-13 and total IgE [TIgE] in asthmatic children during the acute and clinical remission periods, as well as the changes in pulmonary function to determine their roles, relationships and clinical significance during asthma exacerbation. A total of 30 asthmatic children and 22 healthy children were enrolled in the study. The serum eotaxin and IL-13 levels were detected using an enzyme-linked immunosorbent assay and the TIgE level was detected using a fluorescent enzyme-linked immunosorbent assay. The asthmatic children were subjected to pulmonary function tests. The serum eotaxin, IL-13 and TIgE levels of the asthmatic children during the acute period significantly differed from those during clinical remission. The serum eotaxin, IL-13 and TIgE levels of the asthmatic children during both periods significantly differed from those of healthy children [P<0.001]. The serum eotaxin levels during the acute and clinical remission periods were positively correlated with serum IL-13 and with TIgE, and serum IL-13 was correlated with serum TIgE. The pulmonary function indices of asthmatic children during the acute period significantly differed from those during clinical remission [P<0.001]. The serum eotaxin and IL-13 levels in the asthmatic children were positively correlated with the forced expiratory volume in 1 second [FEV1] and the peak expiratory flow [PEF] during the acute and clinical remission periods [P<0.05]. However, the serum TIgE levels in asthmatic children were not significantly correlated with the FEV1 and PEF during both periods [P>0.05]. Serum TIgE, IL-13 and eotaxin influence each other during exacerbation of bronchial asthma and influence the corresponding pathophysiologic changes. Serum IL-13 and eotaxin could be used as markers for evaluating the severity of bronchial asthma
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Objective To explore the impact of levels of serum IL-17,Leukotriene B4 and IgE on pathogenesis of childhood asthma.Methods Totally 60 children with asthma acute exacerbation ( 29 children with mild asthma,31 children with moderate-severe asthma) were selected as study group,24 healthy children were selected as control group.Serum IL-17 and LTB4 were measured with euryzemLinked immunosorbent assay,serum IgE was determined with enzyme-linked fluoroimmuneassay by pharmacia CAP Sytem,PMN was determined with automatic blood analyser,pulmonary function was measured in the study group.Results ( 1 ) The level of serum IL-17 ( 1.15 ± 0.10 μg/L,2.80 ± 2.30 μg/L,0.83 ± 0.10 μg/L),LTB4 (2.22 ± 1.01 μg/L,8.79 ± 9.36 μg/L,1.94 ± 1.13 μg/L) and IgE( 123.70 ±86.94 μg/L,322.27 ±332.28 μg/L,24.27 ±7.64 μg/L) were significantly different among mild asthma group,moderate-severe asthma group and control group( P ＜ 0.001 ).( 2 )The N％ of mild asthma group,moderate-severe asthma group and study group were( 55.06 ± 1 1.15 ) ％,( 64.44± 11.87)％,(47.96 ± 13.52)％,L％ were(42.20 ± 11.04)％,(33.93 ± 10.02)％,(49.65 ± 13.02)％,and there were significant differences in N％ and L％ between study group and control group( P ＜ 0.05 ).( 3 ) There were significant positive correlations between the serum IL-17 levels and IgE,LTB4 and IgE,IL-17 and LTB4 in asthmatic children( P ＜0.05).(4) There were significant negative correlcations between the level of serum IL-17,LTB4 and FEVI,PEF( P ＜0.001 ).There were significant positive correlations between serum IL-17,LTB4 and N％ (P ＜0.001 ).(5)There were not correlations between the level of serum IgE and FEV1,PEF and N％in asthmatic children( P ＞0.05 ).Conclusion The levels of serum IL-17,LTB4 and IgE participated in pathogenesis on asthmatic children patients.
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Objective To study the nosogenesis and the relationship of different levels of serum Eotaxin,IL-13 and total IgE(TIgE)in asthmatic children. Methods Thirty children with asthma aging from 5 to 12 years were selected as study group (attack period and remission period), and 22 healthy children were selected as control group. Serum Eotaxin and IL-13 were measured with enzyme linked immunosorbent assay, and serum TIgE was determined with enzyme-linked fluoroimmune assay in the study group and control group, and pulmonary function was measured at the same time in the study group. Results (1) There were significant differences in pulmonary function between the attack period and the remission period (P ＜ 0. 001). (2) There were significant differences in the level of serum Eotaxin, IL-13 and IgE between the study group and the control group,especially for the attack period and the control group(P ＜0. 001). (3) There were significant positive correlations between the level of serum Eotaxin and IL-13, Eotaxin and TIgE, IL-13 and TIgE respectively in the study group (P ＜0. 05). (4) There were negative correlcations between the level of serum Eotaxin and FEV1 ,PEF,and serum IL-13 and FEV1, PEF in asthmatic children (P ＜ 0. 05), there were no correlations between the level of serum TIgE and FEV1, PEF in the study group (P ＞ 0. 05). Conclusion Serum Eotaxin, IL-13 and TIgE were participated in the nosogenesis of asthma, and the level of serum Eotaxin and IL-13 can be a assessment of asthmatic patients' condition.
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Objective To investigate the relationship between the levels of adiponectin and leptin in umbilical bloods and fetal' s growth and development. Methods Eighty-six neonates bom in our obstetrics department from October 2006 to October 2007 were enrolled the study. According to different birth weight they were divided into small for gestational age infants (SGA) group( n = 16), appropriate for gestational age (AGA) group( n = 41) and large for gestational age (LGA) group ( n = 29 ). After the baby was delivered, 20ml umbilical cord blood was collected immediately.Serum adiponectin and leptin levels of umbilical blood were measured using the radio immunoassay, while blood lipid levels were examined and neonatal growth parameters were measured. Results (1)There were significant difference of umbilical blood leptin and adiponectin levels among three groups ( P < 0.001), which were higher in LGA group than those in AGA and SAG group(P <0.01). (2)There were positive correlations between the serum leptin levels and body weight, gestational age, head circumference, body length, foot length and placental weight( P < 0.01). There were positive correlations between the umbilical blood levels of adiponectin and birth weight, head circumference, foot length and BMI(P<0.05).(3)Umbilical blood leptin levels were significantly positively correlated with adiponectin (P <0.01). (4) Blood lipid levels were not found significant difference among three groups, there were no significant correlation between umbilical blood adiponectin and leptin levels and blood lipids ( P > 0.05). Conclusion Umbilical blood leptin and adiponectin play an important role in fetal growth and developmental processes.