ExacTrac X射线图像引导系统在颅内肿瘤无框架立体定向放射治疗中的价值研究  

Study on the clinical application of ETX image-guided system in FSRT of intracranial tumors

作　　者：陈婷 桂龙刚 李军 CHEN Ting;GUI Long-gang;LI Jun(Radiotherapy Center,Northern Jiangsu People's Hospital,Yangzhou 225001,China)

机构地区：[1]苏北人民医院放疗中心,江苏扬州225000

出　　处：《中国医学装备》2021年第12期10-13,共4页China Medical Equipment

摘　　要：目的:探讨ExacTrac X射线(ETX)图像引导系统在颅内肿瘤的无创立体定向放射治疗(FSRT)中的临床应用价值。方法:选择在医院就诊的30例胶质瘤患者及肺癌脑转移患者,在FSRT治疗前,采用ETX图像引导系统获取六维治疗床校正前的预摆位误差、校正后的残余误差以及利用锥形束CT(CBCT)获取的验证误差,共计3组误差,采用配对t检验、差值占比分析等方法对X方向(左右)的平移误差(X_(t))、Y方向(头脚)的平移误差(Y_(t))、Z方向(前后)的平移误差(Z_(t))及围绕X、Y及Z方向的旋转角度X_(r)、Y_(r)和Z_(r)方向的误差进行数据分析。结果:ExacTrac X图像引导系统校正前各方向上的误差值相对较大,其中X_(t)范围为-4.63~5.11 mm,Y_(t)范围为-6.68~5.43 mm,Z_(t)范围为-5.03~4.88 mm,X_(r)范围为-2.14°~1.91°,Yr范围为-2.34°~2.25°,Zr范围为-2.36°~2.78°;校正后各方向上的误差值明显减小,校正后平移误差≤0.5 mm,旋转方向误差均<0.5°,其中X_(t)范围为-0.48~0.47 mm,Y_(t)范围为-0.48~0.49 mm,Z_(t)范围为-0.48~0.47 mm,X_(r)范围为-0.48°~0.47°,Y_(r)范围为-0.48°~0.48°,Z_(r)范围为-0.42°~0.48°。校正后的摆位误差明显小于校正前,其中X_(t)、Y_(t)、Z_(t)及X_(r)方向上的摆位误差比较差异有统计学意义(t=2.31,t=3.16,t=-2.45,t=-2.48;P<0.05)。ETX残余误差与CBCT所获的验证误差之间的差别很小,且差值占比绝大多数(>91%)在0~1 mm误差的区间上。结论:对于颅内肿瘤FSRT治疗,ETX图像引导系统可以显著减少平移误差和旋转误差,其误差精度与CBCT相差无几,满足高精度的治疗要求。Objective:To explore the clinical application value of ExacTrac X-ray(ETX)image-guided system in frameless stereotactic radiotherapy(FSRT)of intracranial tumor.Methods:30 patients with glioma and brain metastases of lung cancer who admitted to hospital were selected.Before FSRT treatment,the ETX image-guided system was used to obtain the pre-positioning error before the correction of six-dimensional treatment bed and the residual error after the correction,and the verification error was obtained by using cone beam computed tomography(CBCT),and there were a total of 3 sets of errors.Paired t-test,difference ratio analysis and other methods were used to perform data analyses for the translation error(X_(t))on the X direction(left and right),the translation error(Y_(t))on Y direction(head and foot)and the translation error(Z_(t))on the Z direction(front and rear),and the errors of rotation angles of X_(r),Y_(r),and Z_(r) around the X,Y,and Z directions.Results:Before the correction of ETX image-guided system,the error values of various directions were relatively large,and the X_(t) range of them was-4.63-5.11mm,and Y_(t) range of them was-6.68-5.43mm,and Z_(t) range of them was-5.03-4.88mm,and X_(r) range was-2.14°-1.91°,and Yr range was-2.34°-2.25°,and Zr range was-2.36°-2.78°.The error values on various directions were significantly reduced after correction,and the translation error was≤0.5 mm and the error of the rotation direction was less than 0.5°after correction.Among of them,the X_(t) range was-0.48-0.47mm,and Y_(t) range was-0.48-0.49mm,and Z_(t) range was-0.48-0.47mm,and X_(r) range was-0.48°-0.47°,and Yr range was-0.48°-0.48°,and Zr range was-0.42°-0.48°.And positioning error post correction was significantly less than that pre correction,and the differences of positioning errors among X_(t),Y_(t),Z_(t) and X_(r) direction were significant(t=2.31,t=3.16,t=-2.45,t=-2.48,P<0.05),respectively.The difference between the ETX residual error and the verification error obtained by CBCT was very sma

关 键 词：颅内肿瘤 无框架立体定向放射治疗(FSRT) ExacTrac X射线(ETX)图像引导系统 摆位误差 锥形束CT(CBCT) 

分 类 号：R816.1[医药卫生—放射医学]