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四维CT测得部分乳腺外照射者基于金属夹和血清肿确定术腔中心位移比较研究
丁昀, 李建彬, 王玮, 范廷勇, 徐敏, 邵倩, 马志芳, 王素贞
250117 济南大学 山东省医学科学院 医学与生命科学学院 山东省肿瘤医院放疗科
Center displacement of surgical cavity delineated by metal clips and/or seroma on 4DCT in patients for external-beam partial breast irradiation:a comparative study
DING Yun, LI Jian-bin, WANG Wei, FAN Ting-yong, XU Min, SHAO Qian, MA Zhi-fang, WANG Su-zhen
Department of Radiation Oncology, Shandong Tumor Hospital, Medicine and Life Sciences College of Shandong Academy of Medical Sciences, Ji′nan University, Ji′nan 250117, China
Abstract：Objective To conduct a comparative study on the center displacement of surgical cavity delineated by metal clips and/or seroma on four-dimensional computed tomography (4DCT) in patients for external-beam partial breast irradiation (EBPBI) during free breathing. Methods Fourteen breast cancer patients, who had underwent breast-conserving surgery and met the requirements of EBPBI and who underwent 4DCT simulation scans and had a seroma clarity score of ≥3, were included in the study. On the 10 phases of 4DCT images, GTVs were delineated based on metal clips plus seroma, metal clips, and seroma to obtain GTVc+s, GTVc, and GTVs, respectively, and all the metal clips at the boundaries of surgical cavity were marked to obtain the geometry. The three-dimensional center displacements of the geometry, GTVc+s, GTVc, and GTVs as well as four selected metal clips were measured and compared. Results The center displacements of the geometry, GTVc+s, GTVc, and GTVs were 2.20, 0.90, 0.90, and 0.90 mm, respectively, in the left-right (LR) direction, 1.80, 1.20, 1.05, and 1.05 mm, respectively, in the anterior-posterior (AP) direction, and 2.70, 1.40, 1.20, and 0.80 mm, respectively, in the superior-inferior (SI) direction. For each of the geometry, GTVc+s, GTVc, and GTVs, there were no significant differences between the center displacements in the LR, AP and SI directions (χ2=2.05—3.84, P=0.147—0.359). In each of the LR, AP and SI directions, the geometry had a significantly larger displacement than GTVc+s, GTVc, GTVs, and the four selected clips (χ2=15.38—21.022, P=0.000—0.002). The center displacement of GTVc was larger than that of GTVs in the SI direction (Z=－2.05, P=0.041). Conclusions During free breathing, the geometry consisted of all the metal clips has a larger center displacement than GTVc+s, GTVc, GTVs, and the four selected metal clips in the LR, AP and SI directions, but there are no significant differences in center displacement between GTVc+s, GTVc, and GTVs.
DING Yun,LI Jian-bin,WANG Wei et al. Center displacement of surgical cavity delineated by metal clips and/or seroma on 4DCT in patients for external-beam partial breast irradiation:a comparative study[J]. Chinese Journal of Radiation Oncology, 2013, 22(4): 270-273.
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2013, Vol. 22 
