胸部肿瘤调强放疗中实施两相CT图像融合的探讨  

CT image fusion for thoracic tumor radiotherapy in two-phase implementation

作　　者：李宏亮[1] 乔岩[1] 王柯[1] 周立庆[1] 

机构地区：[1]淮安市第二人民医院放疗科,江苏淮安223002

出　　处：《现代肿瘤医学》2015年第22期3265-3267,共3页Journal of Modern Oncology

基　　金：淮安市科技局科研基金项目(编号:HASZ201207)

摘　　要：目的：探讨胸部肿瘤调强放疗中实施两相CT图像融合的应用。方法：选择我院采取调强放射治疗的胸部肿瘤患者34例,患者均采取自由呼吸CT图像采集以及两相CT融合（吸气相和呼气相）,分别在两种CT图像上勾画放疗靶区,然后分别做调强放疗计划,比较两种计划靶区体积以及剂量学参数。结果：自由呼吸CT图像PTVFB的平均体积为（247.52±75.26）cm3,而两相CT图像PTVcom的平均体积为（179.25±73.16）cm3,两者PTV体积比较,差异具有统计学意义（P〈0.05）;两种治疗计划平均剂量、95%处方剂量包含的靶区体积以及均匀性指数均无统计学差异（P〉0.05）,而两相CT靶区适形度指数明显优于自由呼吸CT的靶区适形度指数,差异具有统计学意义（P〈0.05）;两相CT较自由呼吸CT平均肺剂量、脊髓最大剂量以及平均食管剂量显著降低,差异具有统计学意义（P〈0.05）,且两相CT肺V5~V50受照射体积显著低于自由呼吸CT,差异具有统计学意义（P〈0.05）。结论：采用两相CT图像融合技术对胸部肿瘤调强放疗患者进行靶区划定,能够有助于确定足够的边界,避免机体正常组织的过多照射,且实施方法简单可行。Objective： To implement the application of two-phase CT image fusion on chest tumor. Methods： To select 34 patients with chest tumor patients treated by fusion of free breathing CT image acquisition and two-phase CT（ inspiratory and expiratory）,respectively,in two CT images of radiotherapeutic target delineation,and then do the IMRT plan,compare planning volume and dosimetric parameters. Results： The average volume of free breathing CT image PTVFBwas（ 247. 52 ± 75. 26） cm3,and the average volume of two-phase CT image PTVcomis（ 179. 25 ± 73. 16）cm3,the comparison between PTV volume,with significant difference（ P 0. 05）. There were no statistically significant differences between the two treatment plans,average dose prescription dose contains 95% target volume and evenness index（ P 0. 05）,and the two phase CT target region conformal target area index significantly better than free breathing CT conformal index,with significant difference（ P 0. 05）. Phase CT is free breathing CT mean lung dose,the maximum dose of spinal cord and the average esophageal dose significantly reduced,with statistics significant differences（ P 0. 05）,and the two phase CT lung V5~ V50 irradiation volume was significantly lower than that of free breathing CT,with significant difference（ P 0. 05）. Conclusion： Using two-phase CT image fusion technique for target area delineation of thoracic tumor patients with intensity modulated radiotherapy,can help to determine the adequate boundary,and avoid excessive exposure to normal tissue,and the implementation method is simple and feasible.

关 键 词：胸部肿瘤 调强放疗 CT图像融合 

分 类 号：R730.55[医药卫生—肿瘤]