摘要
目的:评价采用心脏勾画图谱对研究者进行统一学习前后,研究者之间全心勾画的变异度、一致性和稳定性。方法:在全盲模式下,由5名具有5年以上临床经验的放疗科医生对,10名拟行放疗的食道癌患者的心脏在增强定位CT横断面上进行勾画,比较学习前后医生勾画心脏的体积大小及稳定性。结果:学习前全组研究者的协方差(COV)、一致性指数(CI)、公共部分体积百分比分别为4.52%±1.73%、72.9%±4.62%和86.6%±3.35%;学习后分别为2.60%±0.92%、79.6%±3.66%和90.3%±3.48%。学习前全组研究者的体积变异百分度及最大体积与最小体积比(Vmax/Vmin)分别为10.3%±3.3%和1.11±0.04;学习后分别为6.3%±2.3%和1.07%±0.02%。所有各项指标与学习前相比,均有显著性差异(P<0.01)。结论:这种由Michigan大学提出的心脏图谱是一种临床非常有用的指南,能够明显降低临床放疗科医生食道癌患者勾画心脏的差异。
Objective： To assess the variability,concordance and stability between inter-observer in the delineation of the whole heart for patients with esophagus cancer before and after studying the heart atlas. Methods： Ten patients with esophagus cancer who subjected to be treated by radiation therapy were asked to contour the heart in computed tomography transverse section in blind mode. The volume and concordance between inter-observer in the delineation of the whole heart was evaluated before and after studying the heart atlas. Results： The coefficient of variance （COV）~ Concordance index （CI） and vintersection for the delineation of heart were： 4.52%±1.73%,72.9%±4.62% and 86.6%±3.35% respectively without cardiac atlas, 2.60%±0.92% 79.6%±3.66% and 90.3%±3,48% respectively with cardiac atlas; The percentage volume variation and Vmax/Vmin were： 10.3%± 3.3% and 1.11 ±0.04 respectively without cardiac atlas, 6.3 %±2.3% and 1.07 % ±0.02% respectively with cardiac atlas. A significant difference were obtainedbetween various indexes before and after studying the heart atlas. Conclusions： This cardiac atlas developed by University of Michigan is a useful guidelines that significantly reduces inter-observer variability in heart volume delineation for patients with esophagus cancer.
出处
《中国医学物理学杂志》
CSCD
2014年第3期4857-4861,共5页
Chinese Journal of Medical Physics
关键词
食道癌
调强放疗
心脏
esophagus cancer
intensity-modulated radiotherapy
heart
