放射组学和剂量组学在寻找肺辐射损伤预测因数方面的应用经验

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论证。放射组学是一种基于机器学习从数字医学影像中提取、分析和解释定量特征的技术。近年来，“剂量组学”一词在文献中越来越常见，标志着放射组学的新方向。剂量组学是一种对放射治疗过程中辐射剂量分布计划进行纹理分析的方法。剂量组学领域已发表的大多数研究都致力于其在预测辐射引起的肺损伤中的应用。

目的 — 利用放射组学的纹理方法和肺部图像的剂量组学分析，以及计算机断层扫描获得的胸部软组织，从而确定肺部辐射损伤的预测因数（生物标志物）。

材料和方法。研究中，使用了36名接受术后适形放射治疗的乳腺癌妇女的数据。根据放疗后肺部变化的程度回顾性地将患者分为两组。使用3D Slicer软件对所有患者在放疗计划阶段获得的CT扫描结果和辐射剂量分布计划进行分析，该软件具有上传研究区域的放射组学和剂量组学指标的功能。选择照射一侧的胸部软组织和肺部区域作为研究区域，剂量负荷分别超过3 Gy和10 Gy。

结果。第一组包括13名放疗后肺部变化最小的患者，第二组包括23名放疗后肺纤维化的患者。在剂量负荷超过3 Gy的照射侧肺区，三项放射组学指标和一项剂量组学指标在患者组间存在显著统计学差异。在剂量负荷超过10 Gy的照射侧肺区，12项放射组学指标和1项剂量组学指标存在显著统计学差异。在照射一侧的胸部软组织区域，18项放射组学指标和4项剂量组学指标存在显著差异。

结论。研究结果表明，在乳腺癌放疗后、肺部放疗后微小变化和放疗后肺纤维化的患者中，一 系列的放射组学和剂量组学指标存在统计学差异。我们根据纹理分析确定的预测因数（生物标志物）可用于预测放射后肺损伤，并确定发生肺损伤的发展风险较高的患者。

作者简介

Nikolay V. Nudnov

Russian Scientific Center of Roentgenoradiology; Russian Medical Academy of Continuous Professional Education; Peoples’ Friendship University of Russia

编辑信件的主要联系方式.
Email: nudnov@rncrr.ru
ORCID iD: 0000-0001-5994-0468
SPIN 代码: 3018-2527

MD, Dr. Sci. (Medicine), Professor

俄罗斯联邦, Moscow; Moscow; Moscow

Vladimir M. Sotnikov

Russian Scientific Center of Roentgenoradiology

Email: vmsotnikov@mail.ru
ORCID iD: 0000-0003-0498-314X
SPIN 代码: 3845-0154

MD, Dr. Sci. (Medicine), Professor

俄罗斯联邦, Moscow

Mikhail E. Ivannikov

Russian Scientific Center of Roentgenoradiology

Email: ivannikovmichail@gmail.com
ORCID iD: 0009-0007-0407-0953
SPIN 代码: 3419-2977

MD

俄罗斯联邦, Moscow

Elina S.-A. Shakhvalieva

Russian Scientific Center of Roentgenoradiology

Email: shelina9558@gmail.com
ORCID iD: 0009-0000-7535-8523

MD

俄罗斯联邦, Moscow

Aleksandr A. Borisov

Russian Scientific Center of Roentgenoradiology

Email: aleksandrborisov10650@gmail.com
ORCID iD: 0000-0003-4036-5883
SPIN 代码: 4294-4736

MD

俄罗斯联邦, Moscow

Vasiliy V. Ledenev

Central Clinical Military Hospital

Email: Ledenevvv007@gmail.com
ORCID iD: 0000-0002-2856-2107
SPIN 代码: 2791-0329

MD, Cand. Sci. (Medicine)

俄罗斯联邦, Moscow

Aleksei Yu. Smyslov

Russian Scientific Center of Roentgenoradiology

Email: smyslov.ay@gmail.com
ORCID iD: 0000-0002-6409-6756
SPIN 代码: 9341-0037

Cand. Sci. (Engineering)

俄罗斯联邦, Moscow

Alina V. Ananina

Russian Scientific Center of Roentgenoradiology

Email: vastruhina.a.v@yandex.ru
ORCID iD: 0009-0002-4562-9729
SPIN 代码: 9699-7690
俄罗斯联邦, Moscow

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2. Fig. 1. Computed tomography of the chest organs of patients 6 months after radiation therapy: a — minimal post—radiation changes in the left lung; b - pronounced post-radiation pneumofibrosis in the right lung.

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