用扩散模型预测肺部质子放疗剂量,融合束流信息提升精度。
DoseBridge: Denoising Diffusion Bridge Model for Dose Prediction in Lung Intensity-Modulated Proton Therapy

- 基于扩散桥模型,用CT和束流掩膜联合建模剂量分布。
- 测试集平均误差4.17 Gy,优于对比模型,关键器官剂量差异小。
- 可灵活调整束流方向,保持靶区高剂量同时改变低剂量区域。
大多数放疗剂量预测模型仅使用CT图像和解剖结构,而强度调制质子治疗(IMPT)的剂量还强烈依赖于束流几何。本文提出DoseBridge,一种去噪扩散桥模型,以患者CT作为结构化终点,并将计划特异的束流几何编码为空间对齐的束流掩膜。多尺度融合结合了CT、靶区、危及器官和束流掩膜表征,仅增加1.95%参数量。在单中心52例晚期肺癌患者(60 Gy/30次)的回顾性数据上评估,其中42例用于训练,10例用于测试。性能通过图像相似性、剂量体积及Lyman-Kutcher-Burman正常组织并发症概率(NTCP)指标评估,对比两种深度学习模型。测试集上,平均绝对误差为4.170 Gy,峰值信噪比23.06 dB,结构相似性0.798,均优于对比模型。临床靶区覆盖度D95与参考剂量偏差为0.62 ± 1.6 Gy;危及器官平均剂量差异为-0.32至0.24 Gy,急性食管炎和放射性肺炎的NTCP差异分别为-0.40 ± 2.2和0.52 ± 3.4百分点。仅更改束流掩膜即可引导预测的低剂量入射区变化,同时保留高剂量靶区。据我们所知,DoseBridge是首个用于放疗剂量预测的去噪扩散桥模型。结果支持其作为肺部IMPT束流感知规划先验的可行性,有待更大外部队列验证。
原文摘要 · Abstract (English)
Most radiotherapy dose-prediction models use only CT images and anatomical structures, although intensity-modulated proton therapy (IMPT) dose also depends strongly on beam geometry and available clinical datasets are often small. We present DoseBridge, a denoising diffusion bridge model that uses the patient CT as a structured bridge endpoint and encodes plan-specific beam geometry in a spatially aligned beam mask. Multiscale fusion combines CT, target, organ-at-risk, and beam-mask representations with 1.95% additional parameters. DoseBridge was retrospectively evaluated on single-institution CT images and treatment plans from 52 patients with advanced-stage lung cancer treated with 60 Gy in 30 fractions; 42 cases were used for training and 10 for testing. Performance was assessed using image-similarity, dose-volume, and Lyman-Kutcher-Burman normal-tissue complication probability (NTCP) metrics and compared with two deep-learning models. On the test cohort, DoseBridge achieved a mean absolute error of 4.170 Gy, peak signal-to-noise ratio of 23.06 dB, and structural similarity index of 0.798, outperforming both comparison models on these metrics. Clinical target volume D95 differed from the reference dose by 0.62 +/- 1.6 Gy; signed organ-at-risk mean-dose differences ranged from -0.32 to 0.24 Gy, and NTCP differences were -0.40 +/- 2.2 and 0.52 +/- 3.4 percentage points for acute esophagitis and radiation pneumonitis, respectively. Changing only the beam mask redirected predicted low-dose entrance regions while preserving the high-dose target region. To our knowledge, DoseBridge is the first denoising diffusion bridge model for radiotherapy dose prediction. These results support its feasibility as a beam-aware planning prior for lung IMPT, pending evaluation in larger external cohorts.
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