Dosimetric study on different bladder filling status in cervical cancer radiotherapy based on artificial intelligence-assisted segmentation(PDF)
《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]
- Issue:
- 2025年第7期
- Page:
- 847-852
- Research Field:
- 医学放射物理
- Publishing date:
Info
- Title:
- Dosimetric study on different bladder filling status in cervical cancer radiotherapy based on artificial intelligence-assisted segmentation
- Author(s):
- QI Yingnan; CHEN Xuemei; CHEN Foping; CHEN Zhanlin; JIANG Xiaobo; XU Senkui; LUO Yu; XIONG Xiaoyue; CHI Feng
- State Key Laboratory of Oncology in South China/Guangdong Provincial Clinical Research Center for Cancer/Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
- Keywords:
- cervical cancer; bladder filling status; artificial intelligence-assisted segmentation; cone-beam computed tomography; dosimetry
- PACS:
- R318；R811.1
- DOI:
- DOI:10.3969/j.issn.1005-202X.2025.07.002
- Abstract:
- Objective To evaluate the dosimetric impact of interfractional bladder fullness variation in volumetric modulatedarc therapy for cervical cancer using artificial intelligence-assisted cone-beam CT (CBCT) image segmentation, and proposean imaging-based quantitative assessment criterion for bladder fullness, providing an objective basis for assessing bladderfilling status during clinical treatment. Methods Fifty patients receiving volumetric modulated arc therapy for cervical cancerwere selected. The criterion for determining bladder fullness was as follow: if the bladder longitudinal diameter measured onthe CBCT mid-sagittal plane was greater than half of the bladder longitudinal diameter measured on the localizable CT, it wasdefined as ≥50% bladder fullness; otherwise, it was defined as <50% bladder fullness. Based on this criterion, two CBCTimages were selected for each patient (representing fractions with ≥50% and <50% fullness, respectively). Borui autocontouring system was applied to re-contour the target areas and organs at risk, followed by dose recalculation. ResultsCompared with ≥50% bladder fullness group, <50% bladder fullness group had significantly increased bladder V40, and smallbowel Dmax, Dmean, V55, V45, V40 (P<0.05), indicating that during interfractional radiotherapy, a CBCT-measured bladderlongitudinal diameter less than half of the bladder longitudinal diameter measured on the localizable CT could serve as apredictor for significantly increased radiation dose to the bladder and small bowel. Correlation analysis revealed that bladdervolume change showed a positive correlation with bladder Dmax change (R=0.45), a significant negative correlation withbladder V30 (R=-0.37), and negative correlations with small bowel Dmax, Dmean, V55, V45, V40 (R=-0.31, -0.41, -0.39, -0.49, -0.61).The correlation results indicate that increasing bladder fullness could reduce the radiation dose to the bladder and smallbowel. Conclusion Artificial intelligence-assisted segmentation confirms that in interfractional radiotherapy for cervicalcancer, when the CBCT-measured bladder longitudinal diameter is less than half of the longitudinal diameter measured on thelocalizable CT, there is a significant increase in radiation dose to OAR. Maintaining an ideal state of bladder fullnesscontributes to reducing the radiation dose to the bladder and small bowel. It is crucial to provide patients with adequatebladder management education before treatment and implement strict bladder volume management strategies duringtreatment fractions.
Last Update: 2025-07-25