1.Application of deep learning in automatic segmentation of clinical target volume in brachytherapy after surgery for endometrial carcinoma
Xian XUE ; Kaiyue WANG ; Dazhu LIANG ; Jingjing DING ; Ping JIANG ; Quanfu SUN ; Jinsheng CHENG ; Xiangkun DAI ; Xiaosha FU ; Jingyang ZHU ; Fugen ZHOU
Chinese Journal of Radiological Health 2024;33(4):376-383
Objective To evaluate the application of three deep learning algorithms in automatic segmentation of clinical target volumes (CTVs) in high-dose-rate brachytherapy after surgery for endometrial carcinoma. Methods A dataset comprising computed tomography scans from 306 post-surgery patients with endometrial carcinoma was divided into three subsets: 246 cases for training, 30 cases for validation, and 30 cases for testing. Three deep convolutional neural network models, 3D U-Net, 3D Res U-Net, and V-Net, were compared for CTV segmentation. Several commonly used quantitative metrics were employed, i.e., Dice similarity coefficient, Hausdorff distance, 95th percentile of Hausdorff distance, and Intersection over Union. Results During the testing phase, CTV segmentation with 3D U-Net, 3D Res U-Net, and V-Net showed a mean Dice similarity coefficient of 0.90 ± 0.07, 0.95 ± 0.06, and 0.95 ± 0.06, a mean Hausdorff distance of 2.51 ± 1.70, 0.96 ± 1.01, and 0.98 ± 0.95 mm, a mean 95th percentile of Hausdorff distance of 1.33 ± 1.02, 0.65 ± 0.91, and 0.40 ± 0.72 mm, and a mean Intersection over Union of 0.85 ± 0.11, 0.91 ± 0.09, and 0.92 ± 0.09, respectively. Segmentation based on V-Net was similarly to that performed by experienced radiation oncologists. The CTV segmentation time was < 3.2 s, which could save the work time of clinicians. Conclusion V-Net is better than other models in CTV segmentation as indicated by quantitative metrics and clinician assessment. Additionally, the method is highly consistent with the ground truth, reducing inter-doctor variability and treatment time.
2.Analysis of factors associated with acute hematologic toxicity in patients receiving chemoradiotherapy for cervical cancer
Haizhen YUE ; Jing YOU ; Hao WU ; Xiaoyan JIANG ; Jinsheng CHENG ; Kuke DING
Chinese Journal of Radiological Health 2024;33(4):440-446
Objective To investigate the clinical characteristics and dosimetric parameters associated with acute hematologic toxicity (AHT) resulting from radiation-induced damage to hematopoietic organs in patients undergoing chemoradiotherapy for cervical cancer and to provide a reference for establishing dose constraints in relevant regions of interest (ROIs) and predicting adverse tissue reactions during the development of clinical treatment plans. Methods A retrospective analysis was conducted on 556 patients with cervical cancer who underwent chemoradiotherapy at our hospital. Univariate (χ2 and t-test) and multivariate (binary logistic regression analyses) methods were employed to investigate the association of clinical factors and pelvic dose-volume parameters with grade ≥ 3 AHT in patients with cervical cancer. Clinical factors comprised patients’ age, clinical stage, pathologic stage, whether the patient had received chemotherapy in the radiotherapy cycle of interest, and dose-volume dosimetric parameters Vx and Dmean for pelvic bone marrow (BM) and femoral head (FH) structures. Results The incidence of AHT among the included cases was 30.4% (169/556). Chi-square analysis of the clinical factors revealed that whether the patient had received chemotherapy, patient’s age, and pathologic stage had a significant impact on AHT. Univariate analysis showed that the factors associated with AHT were mean dose, V5, V10, V15, V20, and V25 of BM and FH; dosimetric parameters such as V35 of FH had a significant impact on the development of AHT. Multivariate logistic regression analysis identified V15 of pelvic BM as an independent risk factor for AHT (P=0.041), with a threshold value of 84.29% as determined by a receiver operating characteristic (ROC) curve. Conclusion Whether a patient had received chemotherapy in the radiotherapy cycle of interest, and patient’s age and pathologic stage can serve as predictors of AHT. V15 of BM is an independent risk factor for AHT development. Therefore, when formulating a treatment plan, it is crucial to ensure that pelvic V15 remains below 84.29% to effectively reduce the incidence of grade ≥ 3 acute bone marrow depression.
3.E2E testing of Cyberknife lung tracking using a homemade lung phantom
Xiao WEI ; Xiangjie MA ; Mingsheng LI ; Zhengzhao ZHANG ; Ya LIU ; Yuze YANG ; Jinsheng CHENG
Chinese Journal of Radiological Health 2024;33(1):1-6
Objective :
To verify the feasibility of using a homemade lung phantom for quality control of Cyberknife by
comparing the measurement results of the homemade lung phantom and CIRS dynamic phantom in E2E testing of Cyberknife lung tracking.
Methods :
The patient treatment process was simulated, including CT positioning, plan design, irra-
diation implementation, film scanning, and analysis using the homemade phantom and CIRS phantom. The two phantoms
were measured five times using MLC under the S7 generation Cyberknife and five times using Iris under the M6 generation
Cyberknife. The differences in measurement results between the two phantoms were analyzed using independent sample t-test.
Results :
For the S7 generation Cyberknife, the statistical analysis of differences between the two phantoms in the detection values on the X-axis, Y-axis, Z-axis, and total deviation showed P values of 0.236, 0.175, 0.289, and 0.668, respect-
ively. For the M6 generation Cyberknife, the statistical analysis showed P values of 0.880, 0.891, 0.573, and 0.433, respect-
ively. The P values were all > 0.05. Therefore, there were no statistically significant differences in the detection results
between the homemade lung phantom and the CIRS phantom under the S7 and M6 generation Cyberknife. The total deviation values were <1.5 mm.
Conclusion
The homemade lung phantom and CIRS phantom have consistent measurement
results in the E2E testing of Cyberknife lung tracking and meet the requirements of Report of AAPM TG-135 and WS 667-
2019 standard. Therefore, the homemade lung phantom is feasible for clinical quality control of Cyberknife.
4.Conditions for the determination of intrinsic uniformity and intrinsic spatial linearity of SPECT
Pei YU ; Hui LIU ; Ying SONG ; Xiaoliang LI ; Jinsheng CHENG ; Quanfu SUN
Chinese Journal of Radiological Health 2023;32(6):661-667
Objective To address the absence of matrix specified for the determination of intrinsic uniformity in the current standard, and to investigate the effect of source distances on intrinsic spatial linearity, the intrinsic uniformity and intrinsic spatial linearity of 16 probes in eight SPECT devices were measured and analyzed with different matrices and source distances, in order to determine the optimal measurement conditions. Methods According to the standard Specification for Testing of Quality Control in Gamma Cameras and Single Photon Emission Computed Tomograph (SPECT) (WS 523—2019), the intrinsic uniformity was measured using 64 × 64 and 256 × 256 matrices and the intrinsic spatial linearity was measured using of 1.7 and 3 m source distances. Results When intrinsic uniformity was measured with the 64 × 64 matrix, more than 50% of the probes showed lower values. When intrinsic spatial linearity was measured with the 3 m source distance, more probes showed lower values. Conclusion The 64 × 64 matrix is recommended for the determination of intrinsic uniformity and a source distance of >5 FOV is recommended for the measurement of intrinsic spatial linearity.
5.Review of the present situation of radiological diagnosis and protection in pet hospitals
Guoqing LIU ; Hui XU ; Jinsheng CHENG ; Quanfu SUN ; Qiaoqiao ZHAO
Chinese Journal of Radiological Medicine and Protection 2023;43(10):833-838
With the rapid development of pet hospitals and the increasing application of radiological diagnosis in China, the protection of staff and assistants in these hospitals is worthy of attention. Based on the progress in international management and research with respect to radiological diagnosis and protection in animal hospitals, this paper presents a brief review of the current situation, existing problems and management regulations of animal hospitals in China. It summarizes typical issues that may be encountered in radiation protection by government departments, animal hospitals, radiation professionals and assistants in animal hospitals. It also puts forward the key points of radiation protection in animal hospitals in China, which can provide scientific suggestion to assist government in decision-making and standardizing and improving the radiation protection in animal hospitals.
6.Radiation protection testing and radiation shielding performance evaluation for a novel self-shielding radiotherapy system
Xiangjie MA ; Mingsheng LI ; Quanfu SUN ; Chengcheng WANG ; Xiao WEI ; Jinsheng CHENG
Chinese Journal of Radiological Medicine and Protection 2023;43(11):906-912
Objective:To evaluate the radiation shielding performance for a novel self-shielded ZAP-X radiotherapy system used for intra-cranial and neck treatments. The present evaluation was performed according to the relevant Chinese national standards and the clinical placement of the radiotherapy system in an unshielded treatment room.Methods:The radiation source of the ZAP-X was a 3 MV linear accelerator. A total of 33 detection sites were selected surrounding the self-shielded system at 1.3, 2.3 and 3.3 m away from the periphery of the equipment. The maximum ambient dose equivalent rate in each irradiation condition was measured accordingly. A commonly used clinical treatment plan was selected to simulate the treatment process. During the delivery of this treatment plan, the cumulative doses of these 33 sites were measured, separately. The applicable current radiation protection standard for radiotherapy in China was chosen to evaluate the radiation shielding performance of the system.Results:According to the measurement result of the ambient dose equivalent rates along the aforementioned perimeter lines, a suggestion was put forward to redefine the existing 1 m controlled area by determining the distance at which the instantaneous dose rate of 10 μSv/h will not be exceeded. This is to meet the requirements of the Chinese standard GBZ 121-2020.Conclusions:According to the existing Chinese national radiation protection standards, the self-shielded radiotherapy system in the unshielded treatment room has the clinical applicability in China. But for such a novel self-shielded system, the corresponding performance testing and radiation protection standards shall be formulated.
7.Droplet freeze-thawing system based on solid surface vitrification and laser rewarming.
Wenxin ZHU ; Ping'an PAN ; Yonghua HUANG ; Wei CHEN ; Sha HAN ; Zheng LI ; Jinsheng CHENG
Journal of Biomedical Engineering 2023;40(5):973-981
Ultra-rapid cooling and rewarming rate is a critical technical approach to achieve ice-free cells during the freezing and melting process. A set of ultra-rapid solid surface freeze-thaw visualization system was developed based on a sapphire flim, and experiments on droplet freeze-thaw were carried out under different cryoprotectant components, volumes and laser energies. The results showed that the cooling rate of 1 μL mixed cryoprotectant [1.5 mol/L propylene glycol (PG) + 1.5 mol/L ethylene glycol (EG) + 0.5 mol/L trehalose (TRE)] could be 9.2×10 3 °C/min. The volume range of 1-8 μL droplets could be vitrified. After comparing the proportions of multiple cryoprotectants, the combination of equal proportion mixed permeability protectant and trehalose had the best vitrification freezing effect and more uniform crystallization characteristics. During the rewarming operation, the heating curve of glassy droplets containing gold nanoparticles was measured for the first time under the action of 400-1 200 W laser power, and the rewarming rate was up to the order of 10 6 °C/min. According to the droplet images of different power rewarming processes, the laser power range for ice-free rewarming with micron-level resolution was clarified to be 1 400-1 600 W. The work of this paper simultaneously realizes the ultra-high-speed temperature ramp-up, transient visual observation and temperature measurement of droplets, providing technical means for judging the ice free droplets during the freeze-thaw process. It is conducive to promoting the development of ultra-rapid freeze-thaw technology for biological cells and tissues.
Freezing
;
Vitrification
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Cryopreservation/methods*
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Trehalose
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Gold
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Rewarming
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Metal Nanoparticles
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Cryoprotective Agents
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Lasers
8.Preliminary experimental analysis of the feasibility of quartz glass for radiotherapy dosimetry
Xiangjie MA ; Zhijian HE ; Jilong YUAN ; Qinghuan JIANG ; Mingsheng LI ; Xiao WEI ; Yuze YANG ; Jinsheng CHENG
Chinese Journal of Radiological Health 2023;32(3):230-234
Objective To explore the feasibility of quartz glass for radiotherapy dosimetry through the experimental study of the thermoluminescence characteristics of synthetic quartz glass. Methods The thermoluminescence glow curves of quartz glass under different annealing conditions were analyzed, the thermoluminescence characteristics of quartz glass were studied, and the measurement parameters were optimized. Using the Co-60 reference radiation field in the National Secondary Standard Dosimetry Laboratory, the quartz glass samples under different annealing conditions were irradiated following the dose levels of radiotherapy, i.e., 0.5, 1.0, 2.0, 4.0, 6.0, 8.0, and 10.0 Gy, respectively. According to the relationship between the absorbed dose of quartz glass and the relative thermoluminescence signal intensity, the linearity and dispersion of the dose response of quartz glass were obtained, and the feasibility of quartz glass for radiotherapy dosimetry was analyzed. Results The linear correlation coefficient of dose response of quartz glass under annealing condition of 430℃ for 10 min was 0.9984, and the dose response dispersion was 0.97% at the absorbed dose of 2 Gy. The linear correlation coefficient of dose response of quartz glass under annealing condition of 600℃ for 1 h was 0.9911, and the dose response dispersion was 1.4% at the absorbed dose of 2 Gy. Conclusion Preliminary results suggest that quartz glass with annealing condition of 430℃ for 10 min has the potential to be used for radiotherapy dosimetry.
9.Influencing factors of medical exposure frequency for community residents
Yuli CAO ; Yinping SU ; Hui XU ; Quanfu SUN ; Jinsheng CHENG
Chinese Journal of Radiological Health 2023;32(2):119-124
Objective To obtain the medical exposure frequency data of residents through a questionnaire survey on mobile phone networks in the community, and to analyze the main influencing factors. Methods A snowball sampling method was used to expand the sampling from medical staff in a county hospital to the community. The questionnaire included personal information such as occupation category, type of medical insurance, and education level as well as basic radiation-related knowledge and medical exposure type and frequency of respondents received in 2021. A logistic regression model was used to analyze the influencing factors of medical exposure. Results A total of 223 respondents were investigated, and 12.56% of them received radiological diagnosis and radiotherapy in 2021. The proportion of males receiving medical exposure was significantly higher than that of females (19.64% vs 10.18%). The likelihood of the person receiving medical exposure increased considerably with age, with the proportion of residents receiving medical exposure at 20, 30, 40, and 50 years of age being 6.25%, 7.95%, 19.23%, and 33.33%, respectively. Of persons who received medical exposure, 57.14% underwent CT scans. Persons participating in the new rural cooperative medical system were likely less to receive radiological diagnosis and radiotherapy than urban workers and residents (OR = 0.55, CI:0.13-2.23, P > 0.05). Conclusion Questionnaire survey in the community can obtain more information about the medical exposure of residents, and age and type of medical insurance are important factors affecting the frequency of medical exposure.
10.Study on correlation between medical exposure and healthcare level in China
Shiyue CUI ; Yinping SU ; Hui XU ; Yantao NIU ; Weihai ZHUO ; Jianxiang LIU ; Jinsheng CHENG ; Quanfu SUN
Chinese Journal of Radiological Medicine and Protection 2023;43(6):440-446
Objective:To study the healthcare level (HCL) in China and its influencing factors.Methods:By using the data reported in the China statistical yearbook published by the National Bureau of Statistics and in other public literature, HCL was calculated in terms of the number of population and physicians in the whole country and various provinces. Multiple regression was used to analyze the relationship between HCL and regional population, area, number of administrative divisions and gross domestic product (GDP). Pearson correlation analysis was applied to analyze the relationship between healthcare level and medical radiation frequency. Results:Since 2015, Chinese HCL value was lower than 1 000, but there were two provinces with HCL value greater than 1 000 in 2019. Population and GDP were the influencing factors for the HCL, with correlation coefficients of 0.416 and -0.583, respectively. There was a correlation between HCL and medical exposure frequency of Chinese population( r= -0.620, P=0.028). Conclusions:Chinese HCL value was 542 in 2020, but there has been great differences between various provinces. HCL as an indicator of medical exposure assessment needs further research in China.


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