双靶区断层治疗图像引导范围对放疗精度的影响

doi:10.3760/cma.j.cn113030-20190917-00007

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摘要目的分析双靶区螺旋断层治疗(HT)中不同图像引导范围对各独立靶区放疗精确度的影响,为临床提供参考。方法 28例双靶区单计划HT患者根据靶区分布情况分为头胸组(15例),胸盆组(13例)。所有患者按整体、头侧靶区、脚侧靶区不同范围进行图像配准,分析各种配准范围下PTV_CT对CTV_MVCT的体积覆盖率、CTV_CT和CTV_MVCT的体积相似性指数及几何中心偏差。结果头胸组和胸盆组结果近似。整体配准时两靶区的覆盖率、体积相似性指数及几何中心偏差差异均无统计学意义(P>0.05)。当只配准某个靶区时,该靶区体积相似性指数和几何中心偏差都明显优于未配准靶区(P<0.05);对于单个靶区而言,单独配准该靶区时所得覆盖率、体积相似性指数及几何中心偏差最优,整体配准时次之,另一侧靶区配准时最差(P<0.05)。结论单独配准某个靶区可能会降低另外靶区的放疗精度,双靶区单计划放疗时图像引导范围应包含所有靶区或者分开配准。

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	刘慧
	彭应林
	孙文钊
	何汇朗
	周凌宏

关键词 ：螺旋断层治疗, 多发转移瘤, 图像配准

Abstract：Objective To analyze the impacts of different registration ranges on the accuracy of multiple metastases treated with helical tomotherapy. Methods According to the locations of target volumes, 28 patients with multiple metastases were divided into the head/chest group (n= 15) and the chest/pelvis group (n= 13). The CT and MVCT images acquired in first fraction were studied and compared in two groups, which were captured and matched with different registration ranges (all targets/the targets in proximity to the head/ the targets in proximity to the foot). The CTV_MVCT volume coverage rate (CR) under the matched target volumes,the dice similarity coefficient (DSC) between the CTV_CT and CTV_MVCT, and the position deviation of the CTV geometric center were compared. Results We observed similar results in the head/chest group and chest/pelvis group. Specifically, there was no significant difference in the CR, DSC and geometric center deviation between the two target regions when registered with all targets (P>0.05). Regarding single target region registration, the DSC and geometric center deviation of this target were significantly superior to the other non-registered target (P< 0.05). To a single target, the CR, DSC, and geometric center deviation obtained with registration presented the best performance, which was significantly greater than these parameters obtained with all targets registration, while the other side target area obtained the worst results (P< 0.05). Conclusions Registration of one target region may reduce the accuracy of other non-registered targets. We recommend that the image guidance ranges for multiple metastases treated with tomotherapy should include all target regions or independent registrations for different targets.

Key words： Helical tomotherapy Multiple metastases Image registration

收稿日期: 2019-09-17

通讯作者: 周凌宏,Email:smart@smu.edu.cn

引用本文:

刘慧,彭应林,孙文钊等. 双靶区断层治疗图像引导范围对放疗精度的影响[J]. 中华放射肿瘤学杂志, 2020, 29(5): 354-357.

Liu Hui,Peng Yinglin,Sun Wenzhao et al. Impacts of different registration ranges on the accuracy of multiple metastases treated with tomotherapy[J]. Chinese Journal of Radiation Oncology, 2020, 29(5): 354-357.

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http://journal12.magtechjournal.com/Jweb_fszlx/CN/10.3760/cma.j.cn113030-20190917-00007 或 http://journal12.magtechjournal.com/Jweb_fszlx/CN/Y2020/V29/I5/354

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