基于光学表面成像与锥形束CT结合的综合引导模式在头颈部肿瘤精确放疗中的研究  

Comprehensive guidance model based on optical surface imaging combined with cone beam CT in head and neck tumors accurate radiation therapy

作　　者：叶程伟 周继丹 商强 周兆明 柏森[1] 钟仁明[1] 邹炳文[1,3] YE Chengwei;ZHOU Jidan;SHANG Qiang;ZHOU Zhaoming;BAI Sen;ZHONG Renming;ZOU Bingwen(Department of Radiation Oncology,Cancer Center,West China Hospital,Sichuan University,Chengdu 610041 China;Guangdong 999 Brain Hospital;Department of Thoracic Oncology,Cancer Center,West China Hospital,Sichuan University)

机构地区：[1]四川大学华西医院肿瘤中心放疗科,四川成都610041 [2]广东三九脑科医院 [3]四川大学华西医院肿瘤中心胸部肿瘤科

出　　处：《中国辐射卫生》2019年第3期346-350,共5页Chinese Journal of Radiological Health

基　　金：四川省科技厅重点研发项目(2017SZ0057)

摘　　要：目的探讨光学表面成像(OSI)Catalyst^TM系统与锥形束CT(CBCT)相结合用于引导头颈部肿瘤精确放疗的临床价值。方法82名患者均来自四川大学华西医院2015年2月至2018年1月收治的需要进行头颈部肿瘤放射治疗的患者,其中45名患者使用OSI-CBCT综合引导放射治疗,37名患者CBCT独立引导治疗。每组患者在治疗疗程中均获得208次有效分次治疗;对综合引导治疗组与独立引导治疗组CBCT所得到的摆位误差数据进行统计学分析。结果独立引导组CBCT扫描得出的分次间摆位误差平移方向x、y、z和旋转方向rx、ry、rz的结果(均值±标准差)分别为(0.19±1.01)mm、(0.29±1.36)mm、(-0.05±1.23)mm,(-0.05±0.65)°、(0.18±0.83)°、(-0.12±0.59)°;综合引导组OSI-CBCT得出的分次间摆位误差的结果分别为(0±1)mm、(0.01±0.98)mm、(-0.4±1.08)mm,(-0.03±0.72)°、(-0.19±0.82)°、(-0.37±0.85)°。两系统的相关性系数分别为:0.17、0.07、0.03、0.1、-0.06、0.01。两系统进行配对样本t检验,结果分别为(0.19±1.3)mm,P<0.05;(0.28±1.62)mm,P<0.05;(0.35±1.62)mm,P<0.05;(-0.03±0.92)°,P>0.05;(0.37±1.2)°,P<0.05、(0.25±1.03)°,P<0.05。结论OSI-CBCT系统综合引导模式在保证放疗精确性的同时可以减少CBCT扫描次数,能有效降低CBCT带来的额外辐射量,在头颈部肿瘤放疗中优于传统的单一的CBCT引导模式。Objective To evaluate the clinical value of Optical Surface Imaging(OSI)Catalyst^TM(C-RAD AB,Sweden)system combined with Cone Beam CT(CBCT)for guiding precise radiotherapy of head and neck tumours.Methods 82 head and neck cancer patients in West China hospital from February 2015 to January 2018 were involved in this analysis,in which 45 patients received OSI-CBCT integrated guided radiotherapy and 37 patients with CBCT independent guided radiotherapy.In the treatment cycle,the OSI-CBCT integrated guided radiotherapy and CBCT guided radiotherapy were carried out,and dates from 208 times of effective fractional treatments were obtained in each group.The position error data obtained from a comprehensive guided treatment group and independent guided treatment group were statistically analyzed.Results The data of the translational directions x(left and right),y(head foot),z(front and back)and the rotational direction of rx(PIT),ry(ROL),rz(ROT)(mean standard deviation)of the inter-segment position error obtained by the CBCT scan of the independent guidance group were(0.19±1.01)mm,(0.29±1.36)mm,(0.05±1.23)mm,and(0.05±0.65)°,(0.18±0.83)°and(-0.12±0.59)°,respectively,when the integrated guide group OSI-CBCT derived placement error data were(0±1)mm,(0.01±0.98)mm,(-0.4±1.08)mm,and(-0.03±0.72)°,(-0.19±0.82)°and(-0.37±0.85)°,respectively.The correlation coefficients of the two systems are:0.17,0.07,0.03,0.1,-0.06,and 0.01,respectively.The correlation coefficients of the two systems subtracting the translation direction x-x1,y-y1,z-z1 and rotational direction rx-rx1,ry-ry1,rz-rz1 were( 0. 19 ± 1. 3) mm,P < 0. 05 and( 0. 28 ± 1. 62) mm,P < 0. 05;( 0. 35 ± 1. 62) mm,P <0. 05;( - 0. 03 ± 0. 92) °,P > 0. 05;( 0. 37 ± 1. 2) °,P < 0. 05、( 0. 25 ± 1. 03) °,P < 0. 05,respectively. Conclusion TheOSI-CBCT system integrated guidance mode can reduce the number of CBCT scans while ensuring the accuracy of radiotherapy,and effectively reduce the extra radiation dose caused by CBCT,which is superior to the tradit

关 键 词：OSI OSI-CBCT综合引导模式 锥形束CT(CBCT) 头颈部肿瘤 放射治疗 摆位误差 

分 类 号：R816.1[医药卫生—放射医学]