肺癌伴肺不张者放疗前MRI与CT模拟定位比较研究

doi:10.3760/cma.j.issn.1004-4221.2016.02.016

Abstract
Figure/Table
References()
Related Citation (15)
Read Tracking
Download Tracking

Download: PDF (885 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS) Supporting Info

Abstract Objective To study the potential of MRI simulation in lung cancer patients with post-obstructive lobar collapse (POLC). Methods 14 patients with POLC were enrolled. Before radiotherapy,two sets of simulating images were obtained for each patient using CT and MRI with T₁/T₂-weighted and diffuse-weighted images (T₁W/T₂WI/DWI). Simulating MRI were fused with corresponding simulating CT for dose calculation. Contrast-to-noise-ratios (CNRs) of tumor and POLC on T₂WI and DWI were measured and calculated. The GTV and OARs were delineated separately by radiation oncologists both on simulating CT and MRI. Plan_CT and Plan_MRI/CT were carried out on CT sets with same beam number and direction. Dose distributions of OARs were compared on the basis of DVH. Results 12 out of 14 cases were distinguishable by T₂WI and all the 6 cases could be figured out by DWI. The mean volume of GTV_MRI was significantly smaller than GTV_CT(149.317±229.670 cm³ vs.178.073±236.604 cm³,P=0.000).The mean CNR of DWI was much higher than T₂WI (77.295±49.273 vs.12.942±5.553,P=0.027).The DVH comparison showed OARs of Plan_MRI got less exposure compared to those of Plan_CT. with no significant differences in HI and CI (The mean dose of lung with cancer was lower (P=0.002),and withno cancer similar (P=0.052). Total lung mean dose was lower (P=0.009),and with esophagus lower (P=0.038). The maximal dose of spinal cord was lower (P=0.038). The V₅,V₁₀ of lung and V₂₅ of heart were lower (P=0.010,0.031,0.044). Conclusions MRI simulation with coregistered simulating CT is more competent than CT simulation alone,in identifying and defining the borderlines of tumor masses and reducing the exposure of OARs.

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	Zhao Dan
	Yu Rong
	Hu Qiaoqiao
	ZHang Jian
	Wu Hao
	Yu Huiming
	Geng Jianhao
	Qi Liping
	Zhu Guangying

Key words： Magnetic resonance imaging simulation Lung neoplasms Post-obstructive lobar collapse
Fund program:National Natural Science Fund of China (30870738,81472814)

Received: 26 April 2015

Corresponding Authors: Zhu Guangying,Email:zgypu163@163.com

Cite this article:

Zhao Dan,Yu Rong,Hu Qiaoqiao et al. Using MRI simulation in radiotherapy of lung cancer with post-obstructive lobar collapse:a preliminary study[J]. Chinese Journal of Radiation Oncology, 2016, 25(2): 158-159.

URL:

http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.issn.1004-4221.2016.02.016 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2016/V25/I2/158

[1]Grills IS,Yan D,Martinez AA,et al. Potential for reduced toxicity and dose escalation in the treatment of inoperable non-small-cell lung cancer:a comparison of intensity-modulated radiation therapy (IMRT),3D conformal radiation,and elective nodal irradiation[J].Int J Radiat Oncol Biol Phys,2003,57(3):875-890.DOI:10.1016/S0360-3016(03)00743-0.
[2]任雯廷,陈辛元,戴建荣.磁共振放疗模拟定位技术应用现状与问题[J].中华放射肿瘤学杂志,2015,24(1):93-96.DOI:10.3760/cma.j.issn.1004-4221.2015.01.025.
Ren WT,Chen XY,Dai JR.Application status and problems of MRI radiotherapy Simulator technology[J].Chin J Radiat Oncol,2015,24(1):93-96.DOI:10.3760/cma.j.issn.1004-4221.2015.01.025.
[3]Qi LP,Zhang XP,Tang L,et al. Using diffusion-weighted MR imaging for tumor detection in the collapsed lung:a preliminary study[J].Eur Radiol,2009,19(2):333-341.DOI:10.1007/s00330-008-1134-3.
[4]ICRU. ICRU Report 62:Prescribing,recording and reporting photon beam therapy (Supplement to ICRU report 50)[R].Bethesda,MD:International Commission on Radiation Units and Measurements,1999:125-210.
[5]Ettinger DS,Wood DE,Akerley W,et al. NCCN clinical practice guidelines in oncology non-small cell lung cancer (version 3.2015),principles of radiation therapy (7 of 9)[EB/OL].Fort Washington:NCCN,2015[2015-06-11].http://www.cjcpt.org/files/2015/03-06/2015-NCCN/2015%20NCCN-NSCLC-V3.pdf.
[6]ICRU. ICRU Report 83:prescribing,recording,and reporting photon-beam intensity modulated radiation therapy (IMRT)[J].J ICRU,2010,10(1):NP.DOI:10.1093/jicru/ndq002.
[7]Kns T,Kristensen I,Nilsson P.Volumetric and dosimetric evaluation of radiation treatment plans:radiation conformity index[J].Int J Radiat Oncol Biol Phys,1998,42(5):1169-1176.DOI:10.1016/S0360-3016(98)00239-9.
[8]Molina PL,Hiken JN,Glazer HS.Imaging evaluation of obstructive atelectasis[J].J Thorac Imaging,1996,11(3):176-186.
[9]Onitsuka H,Tsukuda M,Araki A,et al. Differentiation of central lung tumor from postobstructive lobar collapse by rapid sequence computed tomography[J].J Thorac Imaging,1991,6(2):28-31.
[10]Ebert MA,Kenny J,Greer PB.Experience converting an RT department to full CT simulation:technical issues identified during commissioning of a wide-bore scanner[J].J Med Imaging Radiat Oncol,2009,53(3):325-330.DOI:10.1111/j.1754-9485.2009.02075.x.
[11]Wu V,Podgorsak MB,Tran TA,et al. Dosimetric impact of image artifact from a wide-bore CT scanner in radiotherapy treatment planning[J].Med Phys,2011,38(7):4451-4463.DOI:10.1118/1.3604150.
[12]Ford EC,Herman J,Yorke E,et al.¹⁸F-FDG PET/CT for image-guided and intensity-modulated radiotherapy[J].J Nucl Med,2009,50(10):1655-1665.DOI:10.2967/jnumed.108.055780.
[13]Nestle U,Kremp S,Schaefer-Schuler A,et al. Comparison of different methods for delineation of ¹⁸F-FDG PET-positive tissue for target volume definition in radiotherapy of patients with non-small cell lung cancer[J].J Nucl Med,2005,46(8):1342-1348.
[14]Greco C,Rosenzweig K,Cascini GL,et al. Current status of PET/CT for tumour volume definition in radiotherapy treatment planning for non-small cell lung cancer (NSCLC)[J].Lung Cancer,2007,57(2):125-134.DOI:10.1016/j.lungcan.2007.03.020.
[15]Lutterbey G,Gieseke J,Von Falkenhausen M,et al. Lung MRI at 3.0 T:a comparison of helical CT and high-field MRI in the detection of diffuse lung disease[J].Eur Radiol,2005,15(2):324-328.DOI:10.1007/s00330-004-2548-1.
[16]Gjurchinov D,Stojanovska-Nojkova J,Grunevski M,et al. Radiological and"imaging" methods in TNM classification of non-small-cell lung cancer[J].Prilozi,2007,28(1):155-167.
[17]Sommer G,Wiese M,Winter L,et al. Preoperative staging of non-small-cell lung cancer:comparison of whole-body diffusion-weighted magnetic resonance imaging and ¹⁸F-fluorodeoxyglucose-positron emission tomography/computed tomography[J].Eur Radiol,2012,22(12):2859-2867.DOI:10.1007/s00330-012-2542-y.
[18]Schwenzer NF,Schraml C,Müller M,et al. Pulmonary lesion assessment:comparison of whole-body hybrid MR/PET and PET/CT imaging—pilot study[J].Radiology,2012,264(2):551-558.DOI:10.1148/radiol.12111942.
[19]Ohno Y,Sugimura K,Hatabu H.MR imaging of lung cancer[J].Eur J Radiol,2002,44(3):172-181.DOI:10.1016/S0720-048X (02)00267-X.
[20]Biederer J,Beer M,Hirsch W,et al. MRI of the lung (2/3).Why … when…how?[J].Insights Imaging,2012,3(4):355-371.DOI:10.1007/s13244-011-0146-8.
[21]Bourgouin PM,McLoud TC,Fitzgibbon JF,et al. Differentiation of bronchogenic carcinoma from postobstructive pneumonitis by magnetic resonance imaging:histopathologic correlation[J].J Thorac Imaging,1991,6(2):22-27.
[22]Tobler J,Levitt RG,Glazer HS,et al. Differentiation of proximal bronchogenic carcinoma from postobstructive lobar collapse by magnetic resonance imaging. Comparison with computed tomography[J].Invest Radiol,1987,22(7):538-543.
[23]Baysal T,Mutlu DY,Yologlu S.Diffusion-weighted magnetic resonance imaging in differentiation of postobstructive consolidation from central lung carcinoma[J].Magn Reson Imaging,2009,27(10):1447-1454.DOI:10.1016/j.mri.2009.05.024.
[24]Yang RM,Li L,Wei XH,et al. Differentiation of central lung cancer from atelectasis:comparison of diffusion-weighted MRI with PET/CT[J].PLoS One,2013,8(4):e60279.DOI:10.1371/journal.pone.0060279.
[25]Khoo VS,Dearnaley DP,Finnigan DJ,et al. Magnetic resonance imaging (MRI):considerations and applications in radiotherapy treatment planning[J].Radiother Oncol,1997,42(1):1-15.DOI:10.1016/S0167-8140(96)01866-X.
[26]Krempien RC,Schubert K,Zierhut D,et al. Open low-field magnetic resonance imaging in radiation therapy treatment planning[J].Int J Radiat Oncol Biol Phys,2002,53(5):1350-1360.DOI:10.1016/S0360-3016(02)02886-9.
[27]Ireland RH,Bragg CM,McJury M,et al. Feasibility of image registration and intensity-modulated radiotherapy planning with hyperpolarized helium-3 magnetic resonance imaging for non-small-cell lung cancer[J].Int J Radiat Oncol Biol Phys,2007,68(1):273-281.DOI:10.1016/j.ijrobp.2006.12.068.
[28]Bates EL,Bragg CM,Wild JM,et al. Functional image-based radiotherapy planning for non-small cell lung cancer:a simulation study[J].Radiother Oncol,2009,93(1):32-36.DOI:10.1016/j.radonc.2009.05.018.