ExacTrac X线系统二种不同图像配准序列在头颈部肿瘤放疗中的应用研究  

Application of two diff erent image registration sequences in ExacTrac X-ray system for head and neck cancer radiotherapy

作　　者：赖建军 苏志伟 蒋璐 江皓[1] 喻冰淇 吴竞[1] 吴稚冰 王佳浩 Lai Jianjun;Su Zhiwei;Jiang Lu;Jiang Hao;Yu Bingqi;Wu Jing;Wu Zhibing;Wang Jiahao(Department of Radiation Oncology,Zhejiang Hospital,Hangzhou 310013,China;Department of Radiaion Oncology,Hangzhou Cancer Hospital,Hangzhou 310002,China)

机构地区：[1]浙江医院放疗科,浙江杭州310013 [2]杭州市肿瘤医院放疗科,浙江杭州310002

出　　处：《实用肿瘤杂志》2021年第3期263-267,共5页Journal of Practical Oncology

基　　金：浙江省基础公益研究计划项目(LGF20H160020);浙江省医药卫生科技计划项目(2020PY032)。

摘　　要：目的比较2种不同ExacTrac X线系统(ExacTrac X-ray,ET)图像配准序列与锥形束CT(cone beam CT,CBCT)图像配准序列在头颈部肿瘤放疗中的应用,探讨ET在头颈部肿瘤放疗中的临床最优配准序列。方法选择行调强放射治疗(intensity-modulated radiation therapy,IMRT)的34例头颈部肿瘤患者,每周进行1次图像引导放疗,患者摆位完成后采集ET图像,随后采集CBCT图像并在线校准后进行放疗。离线进行CBCT兴趣区六维配准,ExacTrac兴趣区配准(ExacTrac-volume of interest,ET-VOI)和ExacTrac全图像配准(ExacTrac-full image,ET-full)六维配准,并回顾性比较分析CBCT与2种不同ET配准技术(ET-VOI和ET-full)之间的差异和相关性。结果对患者左右、头脚、矢状面、横断面和冠状面摆位误差统计显示,ET-VOI技术和CBCT之间显示出强相关性(Pearson相关系数:0.6≤r<0.8,均P<0.01)。在人体腹背方向上,ET-VOI和CBCT二者呈极强相关性(r≥0.8,P<0.01)。相对于ET-full技术,ET-VOI技术和CBCT配准的摆位误差数据分布更为接近。结论在应用ET进行头颈部肿瘤图像引导放疗的2种不同图像配准技术中,ET-VOI技术是一种更值得推荐的图像配准序列。Objective To compare the cone-beam computed tomography(CBCT)method with two forms of the ExacTrac(ET)registration method,so as to identify the optimal scheme for the ET image-guidance system in the specific context of head and neck cancer radiotherapy.Methods Thirty-four patients with head and neck tumors who received intensity-modulated radiation therapy(IMRT)were selected and received image-guided radiotherapy once a week.ET images were collected after patients were immobilized on the couch,and then CBCT images were collected and calibrated online for radiotherapy.The 6D registration of CBCT region of interest(ROI),ET volume of interest(ET-VOI)and ET-full image(ET-full)were performed offline,and the differences and correlations between CBCT and two different ET registration techniques(ET-VOI and ET-full)were analyzed retrospectively.Results In the directions of lateral,longitude,pitch,roll and yaw,ET-VOI and CBCT showed strong correlation(Pearson correlation coefficient:0.6≤r<0.8,P<0.01).In the vertical directions of human body,the ET-VOI and CBCT showed extremely strong correlation(r≥0.8,P<0.01).Compared with ET-full technology,the setup error data distributions of the ET-VOI and CBCT were closer.Conclusions Between the two different registration protocols,and in the context of the ET image-guidance system in head and neck radiotherapy,ET-VOI technology is the better scheme.

关 键 词：头颈部肿瘤 调强放射治疗 正交成像 锥形束CT 

分 类 号：R739.91[医药卫生—肿瘤]