100千伏管电压结合低浓度对比剂在NSCLC放疗CT模拟定位中的应用研究

发布时间：2018-10-19 08:04

【摘要】：目的评估100千伏管电压结合低浓度对比剂的CT模拟定位图像质量及放疗靶区勾画准确率,探讨低碘、低辐射放疗CT模拟定位技术的应用价值。方法将60例临床确诊非小细胞性肺癌(NSCLC)且未行手术切除的患者进行CT模拟定位,并随机分为两组:A组为标准组(n=30)使用管电压120 k V及碘帕醇(370 mg I/ml)进行CT扫描;B组为双低组(n=30)使用管电压100 k V及碘克沙醇(320 mg I/ml)。对比剂使用剂量为1.2 ml/kg体重,注射流率3.0 ml/s,使用智能跟踪法进行估算循环时间及触发扫描。所有图像均传输到TPS工作站由两位高年资放疗医师独立进行大体肿瘤体积(GTV)勾画,计算两位医师所勾画的GTV差值,对照两组的GTV差值是否有统计学差异,并对照两组患者的碘摄入量、对比噪声比(CNR)、有效辐射剂量(ED)及对比剂不良反应发生率。结果60例NSCLC患者均能被准确勾画出放疗靶区,两组患者的GTV差值差异无统计学意义,肺动脉强化程度及CNR差异亦无统计学意义;A组患者的ED及碘摄入量高于B组[(5.64±0.38)m Sv vs(3.49±0.49)m Sv,P0.05;(28.51±3.52)g I vs(23.44±3.05)g I,P0.05];A组患者的对比剂轻度不良事件发生率高于B组患者(23.33%vs 10.00%)。结论使用100千伏和碘克沙醇320进行放疗CT模拟定位可获得与120千伏、高浓度碘对比剂同样的放疗靶区勾画准确率,并能较大幅度降低碘摄入量及ED,具有较高的临床应用价值。
[Abstract]:Objective to evaluate the quality of CT analog localization images and the accuracy of radiotherapeutic target delineation in 100kV voltage combined with low concentration contrast agent, and to explore the application value of CT simulation localization technique for low iodine and low radiation radiotherapy. Methods A total of 60 patients with non-small cell lung cancer (NSCLC) who were diagnosed clinically as non-small cell lung cancer (NSCLC) and were not surgically resected were studied by CT simulation. They were randomly divided into two groups: group A (standard group) received CT scanning with 120kV tube voltage and iodipaol (370 mg I/ml) and group B (double low group (NN30) used 100kV tube voltage and 320 mg I/ml iodoxol). The dose of contrast agent was 1. 2 ml/kg body weight and the injection flow rate was 3. 0 ml/s,. The cycle time and trigger scan were estimated by intelligent tracking method. All the images were transmitted to TPS workstation. The gross tumor volume (GTV) was drawn by two senior radiotherapeutic physicians independently. The GTV difference between the two doctors was calculated. Whether there was statistical difference in GTV difference between the two groups, there was no statistical difference between the two groups. Iodine intake, (ED) and adverse reaction rate were compared between the two groups. Results all of the 60 patients with NSCLC were able to draw the target area of radiotherapy accurately. The difference of GTV between the two groups was not statistically significant. The ED and iodine intake of group A was higher than that of group B [(5.64 卤0.38) m Sv vs (3.49 卤0.49) m Sv,P0.05; (28.51 卤3.52) g I vs (23.44 卤3.05) g Igna P0.05], and the incidence of mild adverse events of contrast agent in group A was higher than that in group B (23.33%vs 10.00%). Conclusion using 100kV and iodoxacin 320 for radiotherapy CT simulation localization can obtain the same radiotherapeutic target delineation accuracy as 120kV and high concentration iodine contrast agent, and can greatly reduce iodine intake and ED, has higher clinical application value.
【作者单位】：广东省人民医院放射治疗科CT定位室;
【分类号】：R734.2;R730.55

【参考文献】