肺部肿瘤立体定向放疗技术中基于锥形束CT影像的摆位误差分析

发布时间：2018-02-22 22:38

本文关键词： 锥形束CT 立体定向放疗肺部肿瘤摆位误差　出处：《中国癌症杂志》2017年06期 　论文类型：期刊论文

【摘要】：背景与目的:准确的靶区位置是肺部肿瘤立体定向放疗的重要影响因素。该研究旨在分析在肺部肿瘤患者立体定向放疗中基于锥形束CT(cone-beam CT,CBCT)影像的摆位误差及其影响因素。方法:29例单发肺部恶性肿瘤行立体定向放疗的患者,每次放疗前行CBCT扫描,将得到的CBCT图像与定位CT图像匹配,获得前后、头脚和左右方向的摆位误差值,并计算临床靶区(clinical target volume,CTV)外扩至计划靶区(planning target volume,PTV)的边界。同时,还分析对可能影响摆位误差的临床参数等进行分层比较。结果:29例患者共获得155幅CBCT图像。考虑误差方向时前后、头脚和左右方向摆位误差分别为(-1.68±3.62)、(-1.34±3.90)和(0.36±2.15)mm,只考虑误差数值大小时分别为(3.16±2.42)、(3.29±2.48)和(1.74±1.30)mm。根据摆位误差得到CTV外扩至PTV的边界在前后、头脚和左右方向分别为9.6、10.0和5.3 mm。病灶位于周围的肺部肿瘤患者前后方向摆位误差更大(P=0.007),下肺病灶、右肺病灶、肺转移灶在头脚方向摆位误差更大(P=0.008、0.000和0.000)。结论:肺部肿瘤患者放疗中的头脚和前后方向摆位误差较大,立体定向放疗需采用锥形束CT扫描、呼吸控制等技术以减少摆位误差。
[Abstract]:Background & objective: accurate target location is an important influencing factor of stereotactic radiotherapy for lung tumors. This study was designed to analyze the positioning errors and their images based on cone-beam CT(cone-beam CT images in patients with lung tumors. Methods Twenty-nine patients with single lung malignant tumor received stereotactic radiotherapy. Each time before radiotherapy, CBCT scan was performed, the obtained CBCT images were matched with the positioning CT images, and the errors of the front and back, the head and feet, the left and right directions were obtained, and the clinical target area was expanded to the boundary of the planned target area (target volumePTV). At the same time, The stratified comparison of clinical parameters that may affect the error of pendulum was also analyzed. Results A total of 155 CBCT images were obtained from 29 patients with different errors. The position errors of head and foot were -1.68 卤3.62mm-1. 34 卤3.90) and 0.36 卤2.15mm respectively. When the error value was only taken into account, the errors were 3.16 卤2.42kg 3.29 卤2.48mm and 1.74 卤1.30mmm. according to the pendulum error, the boundary between CTV and PTV was obtained. The head and foot and left and right directions were 9.6m10.0 and 5.3 mm. the foci were located in the surrounding lung tumor patients with greater alignment error (P < 0.007), lower lung lesions, right lung lesions, and the right lung lesions, the right lung lesions, the lower lung lesions, the right lung lesions, and the right lung lesions. The error in head and foot direction of lung metastases is greater than that in head and foot. Conclusion: the error of head and foot in head and foot of lung tumor patients with radiotherapy is larger. Conical beam CT scan and respiratory control should be used in stereotactic radiotherapy in order to reduce the error of pendulum position.
【作者单位】：复旦大学附属肿瘤医院放射治疗科复旦大学上海医学院肿瘤学系;上海交通大学医学院附属瑞金医院放射治疗科;
【分类号】：R730.44;R734.2

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