TOMO-HD图像引导不同部位肿瘤放疗摆位误差的研究  

Study on setup errors for different body carcinoma radiotherapy with image guidance in TOMO-HD

作　　者：王银亮[1] 王慧涛[1] 郑安平[1] 孙晓东[1] 王栋[1] 刘豪佳[1] 秦永鹏 WANG Yinliang;WANG Huitao;ZHENG Anping;SUN Xiaodong;WANG Dong;LIU Haojia;QIN Yongpeng(Department of Radiation Oncology,Anyang Tumor Hospital,Anyang 455000 China)

机构地区：[1]安阳市肿瘤医院放射治疗中心,河南安阳455000

出　　处：《中国辐射卫生》2021年第3期331-338,共8页Chinese Journal of Radiological Health

摘　　要：目的利用TOMO-HD螺旋加速器的MV级扇形束CT研究头颈部、胸部、腹盆部肿瘤在放疗中的摆位误差,为PTV边界的外扩提供数据支持。方法采用TOMO-HD螺旋断层系统分别对30例头颈部、42例胸部和31例腹盆部肿瘤患者每次放疗前行MV级扇形束CT扫描,系统自动重建图像并与治疗计划CT图像进行配准,获得患者左右(X轴)、头脚(Y轴)、腹背(Z轴)、沿Y轴方向的旋转(Fy)方向的摆位误差。计算出X、Y、Z方向的系统误差(∑)和随机误差(σ)并对摆位误差进行正态性检验,计算出PTV的各方向外扩边界。结果共行2593次扫描,头颈部、胸部、腹盆部患者在X轴、Y轴、Z轴、Fy方向(沿Y轴方向的旋转)的摆位误差(μ±s)分别为[(-0.31±2.16)mm、(1.09±3.56)mm、(2.36±2.27)mm、(0.29±0.96)°],[(-0.98±2.95)mm、(-0.45±6.86)mm、(3.79±2.47)mm、(0.18±0.60)°]和[(-0.86±2.85)mm、(-1.59±6.91)mm、(5.77±2.40)mm、(0.20±0.68)°]。头颈部、胸部、腹盆部患者在X轴、Y轴、Z轴方向的系统误差(∑)和随机误差(σ)分别为(1.06 mm和1.84 mm)、(1.93 mm和3.43 mm)、(2.41 mm和2.71mm),(1.10mm和2.56mm)、(3.79mm和5.46mm)、(1.38mm和1.99mm)和(1.39mm和0.87mm)、(4.98 mm和5.69 mm)、(1.19 mm和2.05 mm)。结论根据不同部位的摆位误差频数分布,头颈部、胸部、腹盆部不同部位肿瘤患者的靶区在三维方向上最大运动范围参考值为(5.00,5.00,5.00)mm,(6.63,17.25,16.00)mm和(6.49,16.24,13.60)mm,推荐以此作为图像引导参考。Objective The literature study the setup errors of head and neck,thoracic,abdominal and pelvic tumors by megavoltage fan-beam CT based image guidance in TOMO-HD to provide the margin enlarging from clinic target volume(CTV)to planning target volume(PTV)in treatment planning system of TOMO-HD.Methods 103 patients with head and neck(30 patients),thoracic(42 patients),abdominal and pelvic(31 patients)carcinoma were enrolled.Megavoltage fanbeam CT based image guidance in tomotherapy-HD was used to acquire CT scan before every treatment.The left-right(X),superior-inferior(Y),anterior-posterior(Z)and rotation(Fy)setup errors of patients can be obtained from the tomography image automatically restructured by the system.Calculating the systematic error and the random error in the three dimensions and check whether the setup data accord with the normal distribution or not,then acquire the data expand in the three directions.Results According to 2593 fan-beam CT scans,the shift errors(μ±s)in X,Y,Z and Fy(rotation)of three study group were[(−0.31±2.16)mm、(1.09±3.56)mm、(2.36±2.27)mm,(0.29±0.96)°](head and neck tumor),[(−0.98±2.95)mm、(0.45±6.86)mm、(3.79±2.47)mm,(0.18±0.60)°](thoracic cancer)and[(−0.86±2.85)mm、(−1.59±6.91)mm、(5.77±2.40)mm,(0.20±0.68)°](abdominal and pelvic carcinoma).The systematic errors(∑)and random errors(σ)in X,Y,Z dimensions of patients with head and neck,thoracic,abdominal and pelvic tumors were(1.06 mm and 1.84 mm),(1.93 mm and 3.43 mm),(2.41 mm and 2.71 mm),(1.10 mm and 2.56 mm),(3.79 mm and 5.46 mm),(1.38 mm and 1.99 mm)and(1.39 mm and 0.87 mm),(4.98 mm and 5.69 mm),(1.19 mm and 2.05 mm),respectively.Conclusion It is recommended as a reference for image guidance in TOMO-HD according to the frequency distribution of setup errors,for patients with head and neck,chest and abdominal and pelvic tumors,the maximum range of motion in three dimensions are(5.00,5.00,5.00)mm,(6.63,17.25,16.00)mm and(6.49,16.24,13.60)mm.

关 键 词：螺旋断层放疗 统计分析 摆位误差 系统误差 随机误差 外扩边界 

分 类 号：R816[医药卫生—放射医学]