本書從調強放療的步驟入手，概括介紹常用的放療設備、照射方式、放療目的、放療的生物學原理等；重點介紹調強放療中的計算機應用技術，涉及劑量計算模型、放療計劃系統(tǒng)中的可行性問題，以及線性和非線性規(guī)劃模型、放射生物學模型、帶有劑量體積約束的規(guī)劃模型、多目標規(guī)劃模型、照射角度選擇優(yōu)化模型等。此外，本書對通量圖的生成和調制、基于機器跳數的平滑方法和雙向葉片運動通量圖平滑模型等進行研究；討論自動勾畫的意義、需求和定義等，介紹閾值分割算法、區(qū)域分割算法、分水嶺分割算法和馬爾可夫隨機場分割算法等常見的圖像分割算法，重點介紹一種加入區(qū)域信息的測地線活動輪廓模型、一種改進的V-Net 模型和一種基于等效生物劑量和硬件約束的一體化逆向計劃模型，并介紹凸優(yōu)化求解和劑量驗證等。本書介紹的內容涉及面廣，有助于讀者了解調強放療中的計算機應用技術，適合作為高等學校醫(yī)學影像處理相關專業(yè)研究生和高年級本科生的教材，也適合相關科研人員和對調強放療技術感興趣的讀者閱讀。
蘭義華，南陽師范學院計算機與信息技術學院副教授，博士，博士后。2011年12月博士畢業(yè)于華中科技大學計算機應用技術專業(yè)，2017年11月從華中科技大學軟件工程博士后流動站出站。河南省重點學科計算機應用學科帶頭人，河南省教育廳學術技術帶頭人，南陽市學術技術帶頭人，南陽師范學院"臥龍學者”特聘研究員崗位入選者，計算機學會高級會員。
第1 章 引言······················································································1
1.1 研究背景及意義······································································1
1.1.1 癌癥的嚴重危害·····························································1
1.1.2 癌癥的治療方法·····························································3
1.1.3 放療對于癌癥治療的貢獻················································4
1.1.4 放療技術發(fā)展的巨大潛力················································5
1.2 放療技術的發(fā)展歷史································································8
1.2.1 初級放療時代································································8
1.2.2 常規(guī)放療時代································································9
1.2.3 精準放療時代································································9
1.2.4 小結·········································································.10
1.3 計算機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(tǒng)·················································.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(tǒng)······································································.45
第3 章 調強放療中的規(guī)劃問題···························································.48
3.1 正向調強規(guī)劃和逆向調強規(guī)劃·················································.48
3.1.1 正向調強規(guī)劃·····························································.48
3.1.2 逆向調強規(guī)劃·····························································.49
3.2 調強放療中的數學優(yōu)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(tǒng)中的可行性問題·················································.51
3.5 調強放療中的規(guī)劃模型··························································.51
3.5.1 線性和非線性規(guī)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(yōu)化問題················································.60
3.5.5 規(guī)范化距離信息排序···················································.63
3.5.6 混合整數規(guī)劃模型·······················································.68
3.5.7 多目標規(guī)劃模型··························································.69
3.5.8 照射角度選擇優(yōu)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 基于機器跳數的平滑方法·······················································.83
4.4.1 基于圖像處理的平滑方法存在的問題······························.83
4.4.2 基于多葉準直器的靜態(tài)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 后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 前后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(yī)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(qū)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 基于活動輪廓模型的分割算法·······································125
5.5.6 基于深度學習的分割算法·············································127
5.6 一種加入區(qū)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(qū)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(jié)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(yī)學與硬件約束······························································146
6.1 回歸本質——臨床醫(yī)學目標問題··············································146
6.2 逆向計劃的發(fā)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(yī)學劑量·······················································152
6.6 一種基于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 基于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(yōu)化求解··········································································166
7.1 放療中的凸優(yōu)化技術·····························································166
7.1.1 凸優(yōu)化技術在放療中的應用··········································166
7.1.2 凸優(yōu)化技術的優(yōu)點·······················································166
7.1.3 凸優(yōu)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(yōu)化問題·········································································168
7.4.1 凸優(yōu)化的概念·····························································168
7.4.2 全局最優(yōu)解和局部最優(yōu)解·············································169
7.5 典型的凸優(yōu)化模型································································171
7.5.1 線性規(guī)劃模型·····························································171
7.5.2 線性約束二次規(guī)劃模型················································172
7.5.3 幾何規(guī)劃模型·····························································173
7.6 多目標優(yōu)化中的帕累托最優(yōu)····················································175
7.7 凸優(yōu)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 基于修正策略的劑量計算方法·······································181
8.5.2 基于模型策略的劑量計算方法·······································186
參考文獻·························································································189
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