食管胸上、中段癌放疗位置配准验证研究  

Study of landmarks in upper and mid-thoracic esophageal cancer for image registration

作　　者：薛莹[1] 王建华[1] 李定杰[1] 毛荣虎[1] 田玲玲[1] 

机构地区：[1]河南省肿瘤医院放疗中心,郑州450003

出　　处：《医药论坛杂志》2014年第2期35-37,41,共4页Journal of Medical Forum

摘　　要：目的评估食管胸上、中段癌患者位置验证时使用不同的胸部解剖结构作为配准标志的可行性及其几何精度。方法 35例食管胸上、中段癌患者在每次治疗前使用滑轨CT(CT-on-rail)进行位置验证,选择椎体、主动脉、气管隆突、胸骨柄、锁骨、肺尖分别作为配准标志,可分别获得在左右(LR)、头脚(SI)、腹背(AP)三方向摆位误差值。结果在LR方面,使用不同配准标志差异无统计学意义;在SI方向,锁骨和肺炎与椎体配对比较,其差异具有统计学意义,余配准标志无明显差异;在AP方向,气管隆突和胸骨柄与椎体误差值的比较时P值分别为0.000、0.036,其差异具有统计学意义,余配准标志在此方向无明显差异。结论各配准标志在左右方向限制移动度的差异不明显;在头脚方向可作为配准标志的有椎体、动脉、气管隆突、胸骨柄;在腹背方向可作为配准标志的有椎体、动脉、锁骨、肺尖;不建议在食管胸上、中段癌患者位置验证时在腹背方向使用气管隆突和胸骨柄作为配准标志,也不建议在头脚方向用锁骨和肺尖作为配准标志。Objective To evaluate the feasibility and geometric accuracy using different thoracic anatomical structure as landmarks of upper and mid - thoracic esophageal cancer for image registration. Methods Thirty - five patients with tumors were included in the study. CT - on - rail was used to verify patient position before each treatment and we select- ed the ＂spine＂ ,＂ aorta＂ ,＂ trachea and carina＂ ,＂ manubrium sterni＂ ,＂ clavicle＂ ,＂ apex pulmonis＂ as landmarks to get the geometric accuracy in the left -right （LR） , superoinferior（SI） , and anteroposterior（AP） directions, respectively. Re- sults Mobility was limited in the LR direction for all structures and in the SI direction for the spine, aorta, trachea and carina, manubrium sterni, and in the SI direction for the spine, aorta, clavicle, apex pulmonis. Conclusion In the AP di- rection, using ＂trachea and carina＂ and ＂manubrium sterni＂ is unsuitable ; In the SI direction, using ＂clavicle＂ and ＂a- oex Dulmonis＂ is unsuitable.

关 键 词：放射治疗 摆位误差 图像配准 配准标志 CT—on—rail 

分 类 号：R735.1[医药卫生—肿瘤]