胸部肿瘤患者放疗旋转摆位误差分析  

Evaluation of rotational set-up errors in patients with thoracic neoplasms

作　　者：王艳阳[2] 傅小龙[1] 夏冰[1] 樊旼[1] 杨焕军[1] 任珺[1] 徐志勇[1] 蒋国操[1] 

机构地区：[1]复旦大学上海医学院肿瘤学系复旦大学附属肿瘤医院放疗科,上海200032 [2]宁夏医科大学附属医院放疗科,银川750004

出　　处：《中华放射肿瘤学杂志》2010年第1期44-46,共3页Chinese Journal of Radiation Oncology

基　　金：卫生部临床学科重点项目（2004486）;上海市科委重点项目（34119814）

摘　　要：目的分析量化胸部肿瘤患者放疗旋转摆位误差以及单纯调整平移摆位误差前、后旋转误差的变化。方法回顾性分析在我院参加”千伏锥形束CT（KVCBCT）在线引导放疗剩余摆位误差研究”患者的锥形束CT图像。选择20例患者入组研究，其中肺癌16例、食管癌2例、胸腺瘤2例，中位年龄61岁（19～80岁）。每例患者治疗期间每周行KVCBCT引导放疗分析1次，共分析6次。将20例患者的224幅KVCBCT图像和计划设计CT图像进行离线配准，获取患者旋转摆位误差。患者左右方向的旋转误差为俯仰误差（P1），头脚方向的为滚动误差（R1），前后方向的为偏斜误差（Y1）。分析患者单纯调整平移摆位误差前（P1、R1、Y1）与后（P2、R2、Y2）的旋转摆位误差差异以及相关性。结果胸部肿瘤患者的P1、R1、Y1分别为-0．28°±1．52°、0．21°±0．91°、0．27°±0．78°，其中P1与R1、P1与Y1均相似（t=-1．44，P=0．158；t=1．44，P=0．158），R2与Y2不同（t=2．73，P=0．010）。P2、R2、Y2分别为-0．39°±1．40°、0．23°±0．78°、0．22°±0．87°，其中P2与R2、P2与Y2、R1与Y．均相似（t=1．73，P=0．092；t=1．66，P=0．106；t=1．72，P=0．093）。单纯调整平移摆位误差前后P1与P2、R1与R2、Y1与Y2均相似（t=0．24，P=0．813；t=1．11，P=0．910；t=0．19，P=0．849）。无论是单纯调整平移误差前还是后，3个方向问的旋转摆位误差均无相关性（r1=-0.11，P=0．270；r2=-0．09，P=0．332）。结论3个方向问的旋转摆位误差均无相关性，单纯调整平移摆位误差前、后旋转误差无变化，但俯仰和偏斜旋转误差的校正需得到重视。Objective To assess the rotational set-up errors in patients with thoracic neoplasms. Methods 224 kilovohage cone-beam computed tomography （KVCBCT） scans from 20 thoracic tumor patients were evaluated retrospectively. All these patients were involved in the research of ＂ Evaluation of the residual set-up error for online kilovohage cone-beam CT guided thoracic tumor radiation＂. Rotational set-up errors, including pitch, roll and yaw, were calculated by aligning the KVCBCT with the planning CT, using the semi-automatic alignment method. Results The average rotational set-up errors were - 0.28 °± 1.52°, 0.21°± 0.91° and 0.27°± 0.78° in the left-right, superior-inferior and anterior-posterior axis, respectively. The maximal rotational errors of pitch, roll and yaw were 3.5°, 2.7° and 2.2°, respectively. After correction for translational set-up errors, no statistically significant changes in rotational error were observed. Conclusions The rotational set-up errors in patients with thoracic neoplasms were all small in magnitude. Rotational errors may not change after the correction for translational set-up errors alone, which should be evaluated in a larger sample future.

关 键 词：胸部肿瘤/放射疗法 旋转摆位误差 体层摄影术 X线计算机 千伏锥形束 

分 类 号：R686[医药卫生—骨科学]