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4D-CT特殊重建图像对乳腺癌放疗心脏结构剂量评估影响的研究
苏铭1, 巩贯忠1, 邱小平2, 李倩2, 佟颖1, 尹勇1
1山东省肿瘤医院放射物理技术科,济南 250117; 2南华大学核科学技术学院,衡阳 421001
Study on the effect of 4D-CT special reconstruction image on the evaluation of cardiac structure dose in radiotherapy for breast cancer
Su Ming1, Gong Guanzhong1, Qiu Xiaoping2, Li Qian2, Tong Ying1, Yin Yong1
1Radiation Physics Department of Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Ji'nan 250117, China; 2School of Nuclear Science and Technology, University of South China, Hengyang 421001, China
Abstract：Objective To evaluate the effect of different reconstruction images on cardiac dose evaluation by comparing the differences between 4D-CT series and special reconstruction images in evaluating the dose-volume index of cardiac structures. Methods ECG 4D-CT series were scanned in 15 female patients with left breast cancer. The images of 0-95% 20 phases were reconstructed at an interval of 5% cardiac cycle. The maximum intensity projection (MIP), minimum intensity projection (MinIP), average intensity projection (AIP) and sum intensity projection (SIP) images were obtained by special reconstruction of 4D-CT series. Left ventricle (LV) and left anterior descending coronary artery (LADCA) were delineated on 4D-CT and special reconstruction series, respectively. The intensity-modulated radiation therapy plan of the left breast cancer was designed on the basis of 0% phase, and the cumulative dose (Dose-cumulate) of 20 phases was obtained by deformation registration. The doses of 0% phase were deformed and registered to MIP, MinIP, AIP and SIP images to obtain the corresponding dose distribution. The dose-volume indexes of LV and LADCA based on different CT images were compared. Results In the evaluation of dose-volume index of LV, compared with 4D-CT series, the change rates of V5Gy, V30Gy, V40Gy, Dmax and Dmean on MIP images were 3.8%, 2.0%, 0.9%, 3.8% and 1.7%, respectively. There was significant difference in V5 and Dmax between MIP and 4D-CT (both P<0.05). Compared with 4D-CT, the change rates of Dmax on MinIP, SIP and AIP images were 2.5%, 3.1% and 1.5%, respectively (all P<0.05). In the evaluation of dose-volume index of LADCA, only the change rate of Dmax on four special reconstructed images was<5%(P<0.05). Conclusions In the dose-volume evaluation of LV, the V30Gy, V40Gy and Dmean obtained by MIP are basically equivalent to those obtained by 4D-CT series, which can be used to substitute 4D-CT series to evaluate the dose-volume. The special reconstruction image of LADCA can not replace 4D-CT series.
Su Ming,Gong Guanzhong,Qiu Xiaoping et al. Study on the effect of 4D-CT special reconstruction image on the evaluation of cardiac structure dose in radiotherapy for breast cancer[J]. Chinese Journal of Radiation Oncology, 2021, 30(2): 175-179.
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2021, Vol. 30 
