宫颈癌图像引导放疗中不同配准方法对图像配准精度的影响  

Effects of different registration methods on image registration accuracy in image-guided radiotherapy for cervical cancer

作　　者：曹泓立[1] 李玉胜 裴曦[2] 汪志[1] 杨欣[1] 孙欣[1] 方亚玲 CAO Hong-li;LI Yu-sheng;PEI Xi;WANG Zhi;YANG Xin;SUN Xin;FANG Ya-ling(Department of Radiation Oncology,First Affiliated Hospital of Anhui Medical University,Hefei 200022,China;Center of Radiological Physics,University of Science and Technology of China,Hefei 200022,China)

机构地区：[1]安徽医科大学第一附属医院肿瘤放疗科,安徽合肥230022 [2]中国科学技术大学放射物理中心,安徽合肥230022

出　　处：《中华肿瘤防治杂志》2021年第11期858-863,共6页Chinese Journal of Cancer Prevention and Treatment

基　　金：安徽省自然科学基金(1908085MA27)。

摘　　要：目的比较不同灰度配准方式和不同配准范围对宫颈癌图像引导放疗中图像配准精度的影响,为临床应用提供依据。方法选取安徽医科大学第一附属医院高新院区2019-03-01-2019-10-20经病理确诊的15例原发宫颈癌患者为研究对象,患者首次放疗前均行1次锥形束CT(CBCT)位置验证,之后每周治疗前行1次CBCT验证,共计4次CBCT验证。15例宫颈癌患者计划CT和放疗前摆位CBCT图像以不同灰度值[软组织组(S组,0200 HU)、骨结构组(B组,2001700 HU)、综合感兴趣区内所有信息组(A组,01700 HU)]和不同范围(1靶区或2体廓)分别对图像进行三维和六维配准,比较各组配准在实际治疗时PTV_(CT)对CTV_(CBCT)覆盖率、靶区和危及器官(OAR)相似性指数,并对各组配准数据进行成组或配对t检验。结果15例宫颈癌患者共采集720组数据,三维配准时S1组、S2组、A1组、A2组、B1组和B2组PTV_(CT)对CTV_(CBCT)覆盖率分别为(95.51±2.24)%、(95.31±2.09)%、(95.78±2.03)%、(95.27±2.29)%、(94.98±2.12)%和(95.87±2.31)%;六维配准时S1组、S2组、A1组、A2组、B1组和B2组PTV_(CT)对CTV_(CBCT)的覆盖率分别为(97.42±1.22)%、(97.52±1.22)%、(97.34±1.35)%、(97.64±1.15)%、(96.79±1.99)%和(97.34±1.36)%;相同灰度配准条件,不同配准范围各组数据比较,不同灰度配准条件各组数据比较,差异均无统计学意义,均P>0.05。三维和六维配准时S1组靶区相似性指数分别为0.836±0.060和0.860±0.071,t=-3.230,P=0.006;S2组分别为0.836±0.062和0.860±0.071,t=-3.733,P=0.002;A1组分别为0.838±0.061和0.860±0.071,t=-3.556,P=0.003;A2组分别为0.835±0.063和0.861±0.072,t=-3.828,P=0.002;B1组分别为0.833±0.061和0.855±0.069,t=-3.452,P=0.004;B2组分别为0.837±0.060和0.860±0.071,t=-4.120,P=0.001。三维和六维配准时S1组、S2组、A1组、A2组、B1组和B2组膀胱相似性指数比较,差异均无统计学意义,均P>0.05。三维和六维配准时S1组、S2组、A1组、A2组和B1组直肠相似Objective To compare the effects of different gray-scale registration methods and different registration ranges on the accuracy of image registration in cervical cancer image-guided radiotherapy,and to provide a basis for clinical applications.Methods The case data of 15 patients with primary cervical cancer confirmed by pathology in The Gaoxin Districtof First Affiliated Hospital of Anhui Medical University from March 1,2019 to October 20,2019 were selected as the research subjects.Each patient underwent CBCT location verification once before the first radiotherapy,and CBCT verification once every week before the treatment,a total of 4 times.For 15 patients with cervical cancer,the three-dimension and six-dimension registration were performed respectively on the planned CT and pre-radiotherapy CBCT images according to the different gray values(soft tissue S(0-200 HU),bone structure B(200-1700 HU),and all information A(0-1700 HU)and the different match regions(1 target area/2 body contours),The results were compared in the coverage of PTV_(CT)to CTV_(CBCT)and the dice similarity coefficient(DSC)between the PTV_(CT)and CTV_(CBCT),OARCTand OARCBCT,and each piece together the accurate data for independent samples or paired t test.Results A total of 720 sets of data were collected from 15 patients with cervical cancer.The coverage rates of PTV_(CT)to CTV_(CBCT)in S1,S2,A1,A2,B1 and B2 group were(95.51±2.24)%,(95.31±2.09)%,(95.78±2.03)%,(95.27±2.29)%,(94.98±2.12)%and(95.87±2.31)%in three-dimensional registration.The coverage rates of PTV_(CT)to CTV_(CBCT)in S1,S2,A1,A2,B1 and B2 group were(97.42±1.22)%,(97.52±1.22)%,(97.34±1.35)%,(97.64±1.15)%,(96.79±1.99)%and(97.34±1.36)%in six-dimensional registration.While the data of each group were compared of different registration ranges and same grayscale registration condition,and of different gray-scale registration conditions,the difference was not statistically significant,all P>0.05.On three-dimensional and six-dimensional registration,the target similarity in

关 键 词：宫颈癌 图像引导放疗 图像配准 锥形束计算机断层扫描 相似性指数 

分 类 号：R737.33[医药卫生—肿瘤]