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

doi:10.3760/cma.j.cn113030-20190508-00167

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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.

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	Su Ming
	Gong Guanzhong
	Qiu Xiaoping
	Li Qian
	Tong Ying
	Yin Yong

Key words： Special reconstruction Cardiac structure Dose-volume evaluation Breast neoplasm/radiotherapy

Received: 08 May 2019

Fund:Key Research Program of Shandong Province (2018GSF118048);Key Research Program of Shandong Province (2018GSF118006)

Corresponding Authors: Yin Yong, Email:yinyongsd@126.com

Cite this article:

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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http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.cn113030-20190508-00167 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2021/V30/I2/175

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