锥形束CT观察早期乳癌保乳术后全乳放疗过程中血清肿的体积变化  

Seroma volume change on cone-beam CT during whole breast irradiation for early-stage breast cancer after breast conservative surgery

作　　者：李良[1] 吴广银[1] 雒建超[1] 王权[2] 

机构地区：[1]河南省人民医院放疗科,郑州450003 [2]河南省肿瘤医院放疗科,郑州450008

出　　处：《郑州大学学报（医学版）》2015年第5期679-682,共4页Journal of Zhengzhou University(Medical Sciences)

基　　金：河南省医学科技攻关计划项目142102310087

摘　　要：目的:评价锥形束CT观察早期乳癌保乳术后全乳放疗过程中血清肿体积变化的临床价值。方法:选取32例早期乳癌保乳术后出现血清肿的全乳放疗患者,采用锥形束CT和普通CT分别在每例患者全乳放疗初次和末次进行扫描成像,然后由2名医师分别在两类CT图像上勾画出血清肿大小,并比较两类CT图像上血清肿的体积变化值、血清肿可见度评分(SCS)和适形指数(CI)。结果:锥形束CT和普通CT图像上的血清肿体积变化值分别为(17.5±7.8)和(17.7±7.7)cm3,差异无统计学意义(t配对=1.939,P=0.062)。锥形束CT的SCS和普通CT的SCS一致性较差(Kappa=0.293,P=0.005),但两者呈正相关(rS=0.848,P<0.001)。锥形束CT的血清肿CI值和普通CT的血清肿CI值呈正相关(rP=0.882,P<0.001)。锥形束CT图像上血清肿的CI值和SCS呈正相关(rS=0.843,P<0.001),当SCS≥3分时,其CI值>0.60。结论:锥形束CT可以用来观察早期乳癌保乳术后全乳放疗过程中血清肿的体积变化,尤其是当SCS≥3分时,应用效果最佳。Aim：To evaluate the clinical value of cone-beam CT in assessing the seroma volume change during whole breast irradiation for early-stage breast cancer after breast conservative surgery .Methods：A total of 32 early-stage breast cancer patients who received breast conservative surgery generating seroma and underwent cone -beam CT scans and conven-tional CT scans at both the initial and the last time of whole breast irradiation were collected .Two senior radiation oncolo-gists contoured seroma on all scans.Seroma volume change, seroma clarity score（SCS）, and conformity index（CI） were further examined.Results：The difference in seroma volume change between cone-beam CT [（17.5 ±7.8） cm3 ] and conventional CT [（17.7 ±7.7） cm3] were not statistically significant（tpaired =1.939, P=0.062）.SCS of cone-beam CT was not statistically consistent with SCS of conventional CT （Kappa=0.293, P=0.005）.SCS of cone-beam CT was posi-tively correlated with SCS of conventional CT （rS =0.848, P〈0.001）.CI of cone-beam CT was correlated with CI of con-ventional CT（rP =0.882, P〈0.001）.CI was positively correlated with SCS on cone-beam CT（rS=0.843, P〈0.001）. When SCS was more than 3 on cone-beam CT, CI was higher than 0.60.Conclusion：Cone-beam CT could detect the se-roma volume change during whole breast irradiation for early-stage breast cancer after breast conservative surgery , especially for SCS≥3.

关 键 词：锥形束CT 早期乳癌 全乳放疗 血清肿 

分 类 号：R737.9[医药卫生—肿瘤]