磁共振引导自适应放疗在脑转移瘤中的应用

doi:10.3760/cma.j.cn113030-20210818-00311

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摘要脑转移瘤是常见的继发性恶性肿瘤,放射治疗是重要的局部治疗手段。但由于锥形线束CT（CBCT）等图像引导技术无法较好地实时显示颅内肿瘤体积、形状及瘤周水肿变化,影响了自适应放疗的精准性,限制了大剂量低分次放疗在脑转移瘤中的应用。磁共振（MR）图像具有较高的空间分辨率和软组织对比度,且无额外辐射损伤,较CBCT具有明显优势。MR引导的自适应放疗可以实时影像跟踪治疗过程中颅内肿瘤解剖形变及位置变动,并据此进行在线剂量重建,从而保证肿瘤组织得到足量照射、减少周围重要危及器官受量,达到动态的精准放疗。本文就MR引导自适应放疗在脑转移瘤中的应用进行综述。

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	赵晶晶
	毕楠
	肖建平

关键词 ：肿瘤转移,脑, 放射疗法, 自适应放射疗法, 磁共振引导放射疗法

Abstract：Radiotherapy (RT) is the primary local treatment modality for brain metastases, which are common secondary malignancies. Image-guidance system such as cone beam computed tomography (CBCT) may be not applicable to adaptive radiotherapy (ART), as well as hypofractionated RT in brain metastases, because it cannot clearly show the shrinkage and deformation of intracranial tumors, and the peritumoral edema changes in a real-time manner. Magnetic resonance (MR) image has high spatial resolution and soft tissue contrast and no radiation dose burden compared with CBCT. MR-guided adaptive radiotherapy (MR-gART) allows real-time tracking of deformation and position changes of the intracranial tumors, and enables online planning reconstruction during the treatment process. MR-gART could deliver high dose irradiation to the tumors while reducing the radiation dose of important organs at risk around, which contributes to achieving precision RT. In this work, the application of MR-gART in brain metastases was reviewed.

Key words： Neoplasm metastasis, brain Radiotherapy Adaptive radiotherapy MR-guided radiotherapy

收稿日期: 2021-08-18

通讯作者: 毕楠,Email：binan_email@163.com

引用本文:

赵晶晶,毕楠,肖建平. 磁共振引导自适应放疗在脑转移瘤中的应用[J]. 中华放射肿瘤学杂志, 2023, 32(1): 60-64.

Zhao Jingjing,Bi Nan,Xiao Jianping. Application of MR-guided radiotherapy for brain metastases[J]. Chinese Journal of Radiation Oncology, 2023, 32(1): 60-64.

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http://journal12.magtechjournal.com/Jweb_fszlx/CN/10.3760/cma.j.cn113030-20210818-00311 或 http://journal12.magtechjournal.com/Jweb_fszlx/CN/Y2023/V32/I1/60

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