IGRT技术在肺癌SBRT治疗靶区位置误差测定中的应用
发布时间：2019-01-26 08:18
【摘要】：目的:探讨图像引导放射治疗(image guided radiation therapy,IGRT)技术在测定并校正肺部恶性肿瘤体部立体定向放射治疗(stereotactic body radiation therapy,SBRT)过程中靶区位置误差的意义。方法:选择复旦大学附属肿瘤医院收治的14例肺部恶性肿瘤并接受SBRT的患者。每次治疗前后均进行千伏级锥形束CT(kV-CBCT)扫描,与计划CT图像进行在线配准,校正误差后进行治疗。治疗后再次进行CBCT扫描并配准。分别记录治疗前后靶区位置误差。根据临床靶区(CTV)-计划靶区(PTV)外放公式MPTV(外放)=2.5Σ+0.7σ计算PTV外扩大小。结果:治疗前靶区位置左右、头脚、腹背方向误差最大值分别为10.0mm、16.9mm、8.7mm,误差平均值分别为(2.4±2.8)mm、(3.4±4.6)mm、(2.9±3.4)mm。在线校正并治疗后,靶区位置左右、头脚、腹背方向的误差最大值分别为7.6mm、4.6mm、7.0mm,误差平均值分别为(2.1±2.0)mm、(1.5±1.6)mm、(1.7±2.0)mm。无图像引导PTV外扩大小为左右7.96mm、头脚11.72mm、腹背9.63mm,有图像引导并在线校正PTV外扩大小为左右6.65mm、头脚4.87mm、腹背5.65mm。结论:IGRT技术可即时校正SBRT治疗前由摆位引起的靶区位置误差,并测定治疗过程中的靶区位置移动,能提高治疗精度,并有助于PTV外扩的制定。
[Abstract]:Objective: to investigate the significance of image guided radiotherapy (image guided radiation therapy,IGRT) technique in the determination and correction of target position errors during stereotactic radiotherapy (stereotactic body radiation therapy,SBRT) for lung malignant tumors. Methods: 14 patients with pulmonary malignant tumor and receiving SBRT were selected from tumor Hospital of Fudan University. CT (kV-CBCT) scanning of KV conical beam was performed before and after each treatment, and then the planned CT images were registered online, and the errors were corrected and treated. CBCT scan and registration were performed again after treatment. Target position errors were recorded before and after treatment. According to the (PTV) extrapolation formula of clinical target (CTV)-planned target area MPTV = 2. 5 危 0.7 蟽 the size of PTV extraneous expansion was calculated. Results: before treatment, the maximum errors of target area, head, foot and ventral dorsal direction were 10.0 mm / 16.9 mm / 8.7mm, respectively, and the average error values were (2.4 卤2.8) mm, () 3.4 卤4.6) mm, (2.9 卤3.4 mm., respectively. After on-line correction and treatment, the maximum errors of target position, head and foot, and dorsal direction of abdomen were 7.6mm / 4.6mm / 7.0mm, respectively, and the average error values were (2.1 卤2.0) mm, (/ 1.5 卤1.6) mm, respectively. (1.7 卤2.0) mm. The size of PTV was 7.96mm, 11.72mm, 9.63mm, respectively. The size of PTV was 6.65 mm, 4.87 mm and 5.65 mm respectively, and the size of PTV was about 6.65 mm, 4.87 mm and 5.65 mm respectively. Conclusion: the IGRT technique can correct the target position error caused by pendulum immediately before SBRT treatment, and measure the target position movement in the course of treatment, which can improve the treatment accuracy and contribute to the formulation of PTV extranodation.
【作者单位】： 复旦大学附属肿瘤医院放疗科复旦大学上海医学院肿瘤学系;上海交通大学附属胸科医院放疗科;
【分类号】：R734.2;R730.55
[Abstract]:Objective: to investigate the significance of image guided radiotherapy (image guided radiation therapy,IGRT) technique in the determination and correction of target position errors during stereotactic radiotherapy (stereotactic body radiation therapy,SBRT) for lung malignant tumors. Methods: 14 patients with pulmonary malignant tumor and receiving SBRT were selected from tumor Hospital of Fudan University. CT (kV-CBCT) scanning of KV conical beam was performed before and after each treatment, and then the planned CT images were registered online, and the errors were corrected and treated. CBCT scan and registration were performed again after treatment. Target position errors were recorded before and after treatment. According to the (PTV) extrapolation formula of clinical target (CTV)-planned target area MPTV = 2. 5 危 0.7 蟽 the size of PTV extraneous expansion was calculated. Results: before treatment, the maximum errors of target area, head, foot and ventral dorsal direction were 10.0 mm / 16.9 mm / 8.7mm, respectively, and the average error values were (2.4 卤2.8) mm, () 3.4 卤4.6) mm, (2.9 卤3.4 mm., respectively. After on-line correction and treatment, the maximum errors of target position, head and foot, and dorsal direction of abdomen were 7.6mm / 4.6mm / 7.0mm, respectively, and the average error values were (2.1 卤2.0) mm, (/ 1.5 卤1.6) mm, respectively. (1.7 卤2.0) mm. The size of PTV was 7.96mm, 11.72mm, 9.63mm, respectively. The size of PTV was 6.65 mm, 4.87 mm and 5.65 mm respectively, and the size of PTV was about 6.65 mm, 4.87 mm and 5.65 mm respectively. Conclusion: the IGRT technique can correct the target position error caused by pendulum immediately before SBRT treatment, and measure the target position movement in the course of treatment, which can improve the treatment accuracy and contribute to the formulation of PTV extranodation.
【作者单位】： 复旦大学附属肿瘤医院放疗科复旦大学上海医学院肿瘤学系;上海交通大学附属胸科医院放疗科;
【分类号】：R734.2;R730.55
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