定位CT图像和CT/MR扩散加权成像融合图像对食管癌放疗GTV勾画的比较  

Comparative evaluation of CT and CT/MR DWI images for GTV delineation in precision radiotherapy for esophageal squamous cell carcinoma

作　　者：侯栋梁[1] 房彤[1] 刘博[1] 宋丽楠[1] 孙保锦[1] 陈力[1] 

机构地区：[1]首都医科大学附属北京世纪坛医院放疗科,北京100038

出　　处：《中华放射医学与防护杂志》2014年第12期916-918,共3页Chinese Journal of Radiological Medicine and Protection

摘　　要：目的 比较定位CT图像和CT与磁共振扩散加权成像（MR DWI）融合图像（CT/MRDWI）对食管癌放疗GTV勾画的差异.方法 收集经细胞学或组织病理学证实的20例行根治性放疗的食管鳞癌患者,由6名放疗科医师分别在Pinnacle工作站的定位CT图像上和CT/MR DWI融合图像上勾画食管癌原发灶GTV,不包括转移淋巴结.计算GTV体积的均数、标准差、变异系数（CV=标准差/均数）,最大值与最小值的比（Ratio=最大值/最小值）.比较两组间GTV体积的变异系数CV和最大值与最小值的比值（Ratio）的差异.结果 CT图像上勾画的GTV体积最大差值为55.71 cm3,CT/MR DWI融合图像上勾画的GTV体积最大差值为13.89 cm3（F=12.80,P＜0.05）,两组GTV体积的变异系数分别为0.30±0.08和0.11±0.04,两组GTV体积最大值与最小值的比值分别为2.38±0.62和1.34±0.13,差异有统计学意义（Z=-3.92、-3.92,P＜0.05）.结论 和定位CT图像相比,CT/MR DWI图像融合显示食管癌GTV较为直观,能够在一定程度上提高判断病变范围的一致性,从而减少不同医师间勾画靶区差异性.Objective To evaluate the difference between CT and CT/MR DWI images for gross tumor volume （GTV） delineation in precision radiotherapy for esophageal squamous cell carcinoma.Methods 20 patients with pathologically confirmed as esophageal squamous cell carcinoma were selected for target delineation.The GTV based on CT and CT/MR DWI images of the patients were delineated by six radiation oncologists.The mean,standard deviation,coefficient of variation （CV =standard deviation/mean） of GTV volume,the ratio of minimum value and maximum value （ratio =maximum value/minimum value） of the GTV volume were calculated.And the CV and ratio of the GTV by the two methods were compared.Results The biggest difference of GTV volume on CT and on CT/MR DWI images was 55.71 and 13.89 cm3 （F =12.80,P 〈 0.05）.The CV on CT and CT/MR DWI images were 0.30 ± 0.08,0.11-±0.04 （Z =-3.92,P 〈 0.05）,and the ratio of GTV volume were 2.38 ± 0.62,1.34 ± 0.13,respectively （Z =-3.92,P 〈 0.05）.Conclusions CT/MR DWI images could display GTV more directly,which may help to increase consistency of GTV for esophageal squamous cell carcinoma delineation among different radiation oncologists.

关 键 词：靶区勾画 食管肿瘤 磁共振扩散加权成像 图像融合 

分 类 号：R445.2[医药卫生—影像医学与核医学] R735.1[医药卫生—诊断学]