真空垫制作方式对肺癌立体定向放疗摆位精度影响研究  

Effect of vacuum pad making method on setup accuracy of stereotactic radiotherapy for lung cancer

作　　者：于松茂 孟繁里 康加阜 李俊禹 刘巍巍[1] 卢子红 杨敬贤[1] YU Song-mao;MENG Fan-li;KANG Jia-fu;LI Jun-yu;LIU Wei-wei;LU Zi-hong;YANG Jing-xian(Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education/Beijing),Department of Radiation Oncology,Peking University Cancer Hospital&Institute,Beijing 100142,China;Beijing United Family Hospital New Hope Oncology Center,Beijing 100011,China)

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所放疗科,恶性肿瘤发病机制及转化研究教育部重点实验室,北京100142 [2]北京和睦家医院启望肿瘤中心,北京100011

出　　处：《医疗卫生装备》2019年第12期33-35,40,共4页Chinese Medical Equipment Journal

基　　金：国家自然科学基金（81472814)

摘　　要：目的:研究真空垫制作方式对肺癌立体定向放疗(stereotactic body radiotherapy,SBRT)摆位精度的影响,旨在寻找合理的真空垫制作方法。方法:选取20例SBRT病例,均采用真空垫仰卧位固定,真空垫制作分别采用一高一低(A组)和双侧等高(B组)2种方式,通过锥形束CT(cone beam CT,CBCT)与定位CT图像刚性配准,获取2组患者在X、Y、Z、Rtn、Pitch、Roll 6个方向的配准误差。对2组数据行正态性检验,符合正态分布的行配对样本t检验,其余行非参数检验;对2组数据中超限误差(超过3 mm或1.5°)次数和比例做卡方检验和配对样本t检验。结果:A、B 2组在X、Y、Z、Rtn、Pitch、Roll 6个方向的配准误差取绝对值后分别为(0.19±0.13)与(0.26±0.16)cm、(0.12±0.11)与(0.12±0.10)cm、(0.22±0.14)与(0.34±0.20)cm、(0.64±0.48)与(0.91±0.64)°、(0.81±0.54)与(0.87±0.58)°、(0.67±0.51)与(0.99±0.64)°,在X、Z、Rtn、Roll方向差异具有统计学意义(P<0.05);6个方向超限误差频数差异有统计学意义(P<0.05)。结论:真空垫一高一低制作方式可降低X、Z、Rtn、Roll方向摆位误差、提高重复性,具有较好的临床应用价值。Objective To study the effects of different vacuum pad making methods on the positioning accuracy of stereotactic body radiation(SBRT)for lung cancer,and to find a reasonable vacuum pad making method.Methods Twenty cases of SBRT were selected and fixed in supine position with the vacuum pad.Two methods of making vacuum pad were used:one side higher than the other(group A)and equal height at the two sides(group B).The registration errors in X,Y,Z,Rtn,Pitch and Roll directions were obtained by rigid registration of cone beam CT(CBCT)and localization CT images.Two groups of data were tested for normality,paired sample t test for normal distribution and nonparametric test for the rest;Chi square test and paired sample t test were executed for the number and proportion of overrun error(>3 mm or 1.5°)in the two groups of data.Results The mean±SD of group A and B in the six orientations of X,Y,Z,Rtn,Pitch and Roll were respectively as follows:(0.19±0.13)cm VS(0.26±0.16)cm,(0.12±0.11)cm VS(0.12±0.10)cm,(0.22±0.14)cm VS(0.34±0.20)cm,(0.64±0.48)°VS(0.91±0.64)°,(0.81±0.54)°VS(0.87±0.58)°and(0.67±0.51)°VS(0.99±0.64)°;the differences were significant at X,Z,Rtn and Roll directions(P<0.05);there were significant differences between the overrun errors at the six directions(P<0.05).Conclusion The method by making the vacuum pad with one side higher than the other reduces the setup errors at X,Z,Rtn and Roll directions and gains high repeatability,and thus is worthy promoting clinically.

关 键 词：SBRT 摆位误差 真空垫 真空垫制作方式 

分 类 号：R318[医药卫生—生物医学工程] R815[医药卫生—基础医学]