CT与MR多序列融合指导胶质瘤靶区勾画  

Multi-sequence fusion of CT and MR to guide the delineation of glioma target

作　　者：杨军[1] 王颖拓 李卓然 郭文灵 牛红蕊[1] 李小瑞[1] Yang Jun;Wang Yingtuo;Li Zhuoran;Guo Wenling;Niu Hongrui;Li Xiaorui(Department of Oncology,the First Affiliated Hospital of Xinxiang Medical College,Henan Xinxiang 453100,China;Department of Radiotherapy,Nanyang Central Hospital,Henan Nanyang 473000,China)

机构地区：[1]新乡医学院第一附属医院肿瘤科,河南新乡453100 [2]南阳市中心医院放疗科,河南南阳473000

出　　处：《现代肿瘤医学》2020年第8期1353-1357,共5页Journal of Modern Oncology

摘　　要：目的:探讨CT与MR图像融合在脑胶质瘤术后放疗靶区勾画中的应用价值。方法:收集首诊为脑胶质瘤的30例患者进行术后IMRT,基于颅内外标记法的图像配准融合算法进行CT-MR图像融合,并分别根据CT图像及融合图像由资深放疗医师勾画靶区及危及器官,分组进行t检验比较其体积差异。计算CT及CT-MR图像上相应标记点的距离,并计算其体积重合度及中心位置距离。结果:采用颅内外标记法进行图像融合有着较高融合精度,融合误差均小于2 mm。Ⅲ-Ⅳ级胶质瘤组GTVCT比GTVMR+CT显著性减少,分别为GTVCT:(72.23±36.74) cm^3,GTVMR+CT:(104.23±32.64) cm^3(P=0.043<0.05);CTVCT比CTVMR+CT也显著性降低,分别为CTVCT:(244.24±65.37) cm^3,CTVMR+CT:(346.39±51.54) cm^3(P=0.047<0.05)。CT图像与融合图像的CTV中心位置变化最大,为(7.87±11.54) mm,其次为GTV、脑干,视交叉中心位置变化最小。结论:CT-MR图像融合有助于减少靶区勾画差异性,特别是对有水肿区存在及术后肿瘤残存者价值更大。Objective:To investigate the value of CT and MR image fusion in the delineation of radiotherapy target after glioma surgery.Methods:Thirty patients with gliomas were enrolled for postoperative IMRT.The image registration fusion algorithm based on intracranial and extracranial markers was used for CT-MR image fusion.The images were used by senior radiotherapy physicians based on CT images and fused images.Target area and organs at risk were grouped for t-test to compare their volume differences.Calculate the distance of the corresponding points on the CT and CT-MR images,and calculate the volume coincidence degree and the center position distance. Results: Image fusion using intracranial and extracranial markers had a high fusion accuracy,and the fusion error was less than 2 mm. Among them,the GTVC T of the Ⅲ-Ⅳglioma group was significantly less than that of GTVM R + CT[( 72. 23 ±36. 74) cm^3 vs( 104. 23 ± 32. 64) cm^3]( P = 0. 043 < 0. 05). CTVC T was also significantly decreased than CTVM R + CT[( 244. 24 ± 65. 37) cm^3 vs( 346. 39 ± 51. 54) cm^3]( P = 0. 047 < 0. 05). In addition,the CTV center position of the CT image and the fused image changed the most,being( 7. 87 ± 11. 54) mm,followed by GTV and brainstem,and the position of the optic chiasm was the smallest. Conclusion: CT-MR image fusion can help to reduce the difference of target delineation,especially for the presence of edema and postoperative tumor residual.

关 键 词：体层摄影术 X线算机 磁共振成像 图像融合 脑瘤/放射疗法 

分 类 号：R739.41[医药卫生—肿瘤]