锥形束CT引导下乳腺癌保乳术后调强放疗摆位误差及配准方式分析

发布时间：2018-02-24 17:40

  本文关键词： 乳腺肿瘤 放射疗法 调强适形 锥形束CT 配准 摆位误差　出处：《中国全科医学》2017年15期 　论文类型：期刊论文

【摘要】：目的探讨机载锥形束CT(CBCT)引导下乳腺癌保乳术后调强放疗(IMRT)不同乳腺厚度时摆位误差及配准方式的差异。方法 2016年3—10月,选择温州医科大学附属第一医院放化疗科接受IMRT的乳腺癌保乳术后患者85例,在医科达Synergy加速器上的机载CBCT引导下,对IMRT治疗前摆位进行验证。把CBCT重建图像和计划图像进行匹配。计算六维方向上的摆位误差,并在线自动校准上述误差。线下分别测量每例患者乳腺厚度(乳腺组织最大径,即乳腺组织最凸点至最近胸壁肌外缘的距离)并分组,对比分析自动骨性配准下和自动灰度配准下X轴(左右)、Y轴(上下)、Z轴(前后)及矢轴位(GX)、冠状位(GY)、横状位(GZ)的摆位误差。结果自动骨性配准下和自动灰度配准下,85例患者X轴和GY的摆位误差间差异有统计学意义(P0.05)。自动骨性配准下A组(乳腺厚度≤30 mm)、B组(乳腺厚度30~45 mm)、C组(乳腺厚度45 mm)患者各个方向的摆位误差间差异均无统计学意义(P0.05);自动灰度配准下3组患者各个方向的摆位误差间差异均无统计学意义(P0.05)。结论乳腺癌保乳术后IMRT不同乳腺厚度患者摆位误差间无明显差异,两种配准方式建议首先使用灰度配准。放疗前进行CBCT引导下摆位误差校准,可以提高乳腺癌放疗的精度,从而实现精确放疗。
[Abstract]:Objective to investigate the difference of setting error and registration method in different breast thickness after intensity-modulated radiotherapy (IMRT) guided by CT-CBCT.Methods from March to October, 2016. Eighty-five breast cancer patients who received IMRT in the Department of radiotherapy and chemotherapy, first affiliated Hospital of Wenzhou Medical University, were selected under the guidance of airborne CBCT on the Synergy accelerator. The CBCT reconstruction image was matched with the planned image. The error in six dimensional direction was calculated, and the error was automatically calibrated online. The breast thickness (the maximum diameter of mammary tissue) was measured under the line, respectively. The distance between the most salient spot of breast tissue and the nearest outer edge of the chest wall muscle. Comparative analysis is made of the pendulum errors of the X axis (left and right) under the automatic bone registration and the automatic grayscale registration (upper and lower Z axis (front and back) and sagittal axis (GXT), coronal position (GY), transverse position (GZ)). Results the results of automatic bone registration and automatic gray level registration are as follows: (1) automatic bone registration and (2) automatic grayscale registration. There was significant difference in the error between X axis and GY in 85 cases of inferior mammary gland. The difference between the errors in all directions in group A (breast thickness 鈮，

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