調強放療中電腦應用技術研究

第1 章 引言······················································································1
1.1 研究背景及意義······································································1
1.1.1 癌症的嚴重危害·····························································1
1.1.2 癌症的治療方法·····························································3
1.1.3 放療對於癌症治療的貢獻················································4
1.1.4 放療技術發展的巨大潛力················································5
1.2 放療技術的發展歷史································································8
1.2.1 初級放療時代································································8
1.2.2 常規放療時代································································9
1.2.3 精準放療時代································································9
1.2.4 小結·········································································.10
1.3 電腦應用技術對調強放療技術的支撐作用·······························.11
第2 章 放療中的硬件及放療計劃系統·················································.13
2.1 放療的分類·········································································.13
2.1.1 基本概念···································································.13
2.1.2 放療設備···································································.17
2.1.3 照射方式···································································.28
2.1.4 放療目的···································································.32
2.1.5 放療手段和技術··························································.33
2.1.6 劑量分割方式·····························································.37
2.2 放療的生物學原理································································.38
2.3 調強放療的步驟···································································.40
2.4 調強放療中的射線調制設備····················································.43
2.5 逆向計劃系統······································································.45
第3 章 調強放療中的規劃問題···························································.48
3.1 正向調強規劃和逆向調強規劃·················································.48
3.1.1 正向調強規劃·····························································.48
3.1.2 逆向調強規劃·····························································.49
3.2 調強放療中的數學優化問題····················································.49
3.3 劑量計算模型和相關描述·······················································.50
3.4 放療計劃系統中的可行性問題·················································.51
3.5 調強放療中的規劃模型··························································.51
3.5.1 線性和非線性規劃模型················································.51
3.5.2 放射生物學模型··························································.53
3.5.3 劑量體積約束模型·······················································.56
3.5.4 劑量體積約束優化問題················································.60
3.5.5 規範化距離信息排序···················································.63
3.5.6 混合整數規劃模型·······················································.68
3.5.7 多目標規劃模型··························································.69
3.5.8 照射角度選擇優化模型················································.72
第4 章 通量圖的平滑方法·································································.75
4.1 通量圖的生成和調制·····························································.75
4.2 通量圖的平滑······································································.78
4.3 圖像去噪原理······································································.79
4.4 基於機器跳數的平滑方法·······················································.83
4.4.1 基於圖像處理的平滑方法存在的問題······························.83
4.4.2 基於多葉準直器的靜態調強放療的劑量調制過程···············.84
4.4.3 無葉片碰撞約束的模型················································.87
4.4.4 後驅葉片同步約束模型················································.88
4.4.5 前驅葉片同步約束模型················································.90
4.4.6 前後葉片中心時長同步模型··········································.91
4.4.7 舌槽欠劑量效應的直接約束··········································.94
4.4.8 帶葉片碰撞約束的模型················································.95
4.5 雙向葉片運動通量圖平滑模型·················································.96
4.5.1 雙向葉片運動通量圖平滑模型介紹·································.96
4.5.2 實驗及結果分析··························································.99
第5 章 自動勾畫技術·······································································103
5.1 自動勾畫的意義···································································103
5.2 手動勾畫的問題和自動勾畫的需求···········································104
5.3 放療中自動勾畫的定義··························································105
5.4 放療中需要自動勾畫的醫學影像··············································106
5.5 圖像分割算法······································································107
5.5.1 閾值分割算法·····························································107
5.5.2 區域分割算法·····························································113
5.5.3 分水嶺分割算法··························································118
5.5.4 馬爾可夫隨機場分割算法·············································121
5.5.5 基於活動輪廓模型的分割算法·······································125
5.5.6 基於深度學習的分割算法·············································127
5.6 一種加入區域信息的測地線活動輪廓模型及在乳腺鉬靶X 射線
攝片分割中的應用································································130
5.6.1 一種加入區域信息的測地線活動輪廓模型························130
5.6.2 實驗及結果分析··························································132
5.7 一種改進的V-Net 模型及其在肺結節分割中的應用···············139
5.7.1 一種改進的V-Net 模型·················································139
5.7.2 實驗及結果分析··························································142
第6 章 生物醫學與硬件約束······························································146
6.1 回歸本質——臨床醫學目標問題··············································146
6.2 逆向計劃的發展階段及目前存在的問題·····································146
6.3 臨床放療物理劑量特性··························································148
6.4 細胞殺滅存活理論································································149
6.5 分次治療及生物醫學劑量·······················································152
6.6 一種基於等效生物劑量和硬件約束的一體化逆向計劃模型············156
6.6.1 等效生物劑量及模型設計·············································156
6.6.2 基於多葉準直器的硬件約束設計····································159
6.6.3 調強放療一體化逆向計劃模型構建·································161
6.6.4 等效生物劑量模型驗證和分析·······································162
第7 章 凸優化求解··········································································166
7.1 放療中的凸優化技術·····························································166
7.1.1 凸優化技術在放療中的應用··········································166
7.1.2 凸優化技術的優點·······················································166
7.1.3 凸優化技術的局限性···················································166
7.2 凸集的概念·········································································167
7.3 凸函數和保凸運算································································167
7.3.1 凸函數······································································167
7.3.2 保凸運算···································································168
7.4 凸優化問題·········································································168
7.4.1 凸優化的概念·····························································168
7.4.2 全局最優解和局部最優解·············································169
7.5 典型的凸優化模型································································171
7.5.1 線性規劃模型·····························································171
7.5.2 線性約束二次規劃模型················································172
7.5.3 幾何規劃模型·····························································173
7.6 多目標優化中的帕累托最優····················································175
7.7 凸優化中的內點法································································175
第8 章 劑量驗證·············································································177
8.1 放射線電離輻射特性差異·······················································177
8.2 質量控制誤差分配································································177
8.3 多級質量保證和驗證·····························································178
8.4 劑量驗證方法和工具·····························································180
8.5 獨立計算式劑量驗證方法·······················································181
8.5.1 基於修正策略的劑量計算方法·······································181
8.5.2 基於模型策略的劑量計算方法·······································186
參考文獻·························································································189