运动对小体积肿瘤影像学差异的研究  

Study on the Imaging Differences of Small Volume Tumors by Motion

作　　者：刘苓苓[1,2,3] 费振乐 崔相利 李洁[1,3] 牛振洋 王宏志[1,2,3] LIU Lingling;FEI Zhenle;CUI Xiangli;LI Jie;NIU Zhenyang;WANG Hongzhi(Institute of Health and Medical Technology(Anhui Province Key Laboratory of Medical Physics and Technology),Hefei Institutes of Physical Science,Chinese Academy of Sciences,Hefei Anhui 230031,China;Science Island Branch,Graduate School of USTC,Hefei Anhui 230026,China;Radiotherapy Center,Hefei Cancer Hospital,Chinese Academy of Sciences,Hefei Anhui 230031,China;Cancer Diagnosis and Treatment Center,No.901 Hospital of Joint Logistics Support Force of PLA,Hefei Anhui 230031,China)

机构地区：[1]中国科学院合肥物质科学研究院健康与医学技术研究所(医学物理与技术安徽省重点实验室),安徽合肥230031 [2]中国科学技术大学研究生院科学岛分院,安徽合肥230026 [3]中国科学院合肥肿瘤医院放疗中心,安徽合肥230031 [4]中国人民解放军联勤保障部队第901医院肿瘤诊疗中心,安徽合肥230031

出　　处：《中国医疗设备》2022年第4期1-5,18,共6页China Medical Devices

基　　金：国家重点研发计划(2018YFE0114100);安徽省重点研究与开发计划(1804h08020279,202004j07020052);中国科学院合肥肿瘤医院优秀医学青年人才计划(2000000005)。

摘　　要：目的运用呼吸运动平台及CT影像学探索运动对小体积肿瘤体积的影响。方法用立体光刻(Stereo Lithography Appearance,SLA)光敏树脂3D打印为9个直径10~50 mm、直径间隔5 mm的实心球体模拟肿瘤。将9个球体固定在QUASAR呼吸运动平台上,呼吸运动平台带动球体做正弦运动模拟人体头脚方向呼吸运动。设置CT扫描层厚为2、3和5 mm,分别扫描0~15 mm共15个不同呼吸幅度的球体图像,并传输至计划系统,逐个勾画球体。结果仅扫描床移动可使9个球体体积偏差大小为8.43%~120%;而扫描床和呼吸运动两者共同运动对肿瘤靶区体积大小的影响对肿瘤大小、运动幅度有依赖性,直径10 mm肿瘤体积偏差为38.5%~505%,对幅度、层厚依赖性最大;直径15~50 mm肿瘤在呼吸幅度为<1.5、2~3.5和4~15 mm时,对应的肿瘤靶区体积偏差分别为1.05%~45.6%、-6.41%~72.4%、-23.5%~139%。呼吸运动对肿瘤靶区体积大小的影响与其体积大小、呼吸幅度有关,直径小于20 mm的肿瘤靶区体积偏差为-26.9%~175%;直径20~50 mm的肿瘤靶区在呼吸幅度为<2、2~5和>5 mm时,对应的肿瘤靶区体积偏差分别为-10%~10%、-20%~20%和-29.9%~113%。结论肿瘤体积越小,越容易受运动幅度、扫描层厚影响。扫描床移动和呼吸运动对小体积肿瘤的影响不可忽视。对于直径小于50 mm的小体积肿瘤,建议做呼吸运动管理并选择薄层扫描。Objective To explore the influence of motion on the target volume of a small tumor by using respiratory motion platform and CT imaging.Methods Stereo lithography appearance(SLA)photosensitive resin was used to 3D print 9 solid spheres with diameters ranging from 10 to 50 mm and interval 5 mm to simulate the tumors.The spheres were fixed on the QUASAR respiratory motion platform.The platform drove the spheres into sinusoidal motion to emulate the respiratory motion of human head and feet direction.Images of spheres corresponding to breathing amplitudes of 0 to 15 mm were captured using CT scans with layer thicknesses of 2,3 and 5 mm.The images were transferred to the treatment planning system,and the spheres were reconstructed individually.Results The volume deviation of 9 spheres was 8.43%~120%only when the scanning table moved.The effect of the movement of the scanning couch and the breathing motion on the volume of the tumor target was dependent on the size of the tumor and the amplitude of motion.The movement led to deviations of 38.5%to 505%in the volume of the 10-mm-diameter sphere,which was with the greatest dependence on amplitude and layer thickness.In relation,for the spheres with diameters from 15 to 50 mm,the deviations in the volume were ranged from 1.05%to 45.6%when the breathing amplitude was less than 1.5 mm,from-6.41%to 72.4%when the breathing amplitude was between 2 and 3.5 mm,and from-23.5%to 139%when the breathing amplitude was between 4 and 15 mm.On the other hand,the effect of breathing movement on the volume of the tumor target area was dependent on its volume and respiratory amplitude.The deviations in the sphere volume ranged from-26.9%to 175%when the diameter of the sphere was smaller than 20 mm.If the diameter of the sphere was between 20 and 50 mm,the deviations in the sphere volume ranged from-10%to 10%when the breathing amplitude was within 2 mm,from-20%to 20%when the breathing amplitude was between 2 and 5 mm,and from-29.9%to 113%when the breathing amplitude was beyond 5 mm.Conclusio

关 键 词：肿瘤影像学 小体积肿瘤 呼吸运动 体积偏差 CT扫描 

分 类 号：R445.2[医药卫生—影像医学与核医学]