MRI-CT图像融合技术在颈椎肿瘤靶区勾画中的应用  

Application of MRI-CT image fusion technology in delineation of cervical tumor target area

作　　者：张冬艳 薛雁山[2] 许芳 宋晓婕 颜宝云 ZHANG Dongyan;XUE Yanshan;XU Fang;SONG Xiaojie;YAN Baoyun(Department of Imaging,Affiliated Hospital of Shanxi University of Traditional Chinese Medicine,Taiyuan 030024,China;Department of Imaging,Second Hospital of Shanxi Medical University,Taiyuan 030000,China;Department of Oncology,Affiliated Hospital of Shanxi University of Traditional Chinese Medicine,Taiyuan 030024,China)

机构地区：[1]山西中医药大学附属医院影像科,山西太原030024 [2]山西医科大学第二医院影像科,山西太原030000 [3]山西中医药大学附属医院肿瘤科,山西太原030024

出　　处：《中国医学物理学杂志》2022年第5期551-555,共5页Chinese Journal of Medical Physics

基　　金：山西省卫生健康委科研项目(2019163)。

摘　　要：目的:探讨基于MRI-CT图像融合技术对颈椎肿瘤靶区勾画和剂量参数的影响。方法:收集11例颈椎肿瘤放疗患者的影像学资料,将MRI与CT图像进行融合,比较MRI-CT与CT为基础图像的靶区体积差异以及剂量差异。对不同医师所勾画的靶区体积以及剂量差异进行比较分析。实施组内相关系数(ICC)可靠性分析。结果:(1)由1名肿瘤放疗医师所勾画靶区体积GTV_(MRI-CT)显著大于GTV_(CT),脊髓_(MRI-CT)体积显著小于脊髓_(CT)(P<0.05);5名肿瘤放疗医师所勾画靶区体积比较差异与1名肿瘤放疗医师趋势一致,不同影像为基础的靶区勾画体积重叠系数为0.83±0.15。(2)5名肿瘤放疗医师所勾画靶区,GTV以及脊髓变异系数(CV)_(MRI-CT)均小于CV_(CT);ICC在GTV中分别为0.97与0.95,在脊髓为0.83与0.82。(3)GTV剂量MRI-CT D_(max)显著低于CT D_(max),脊髓剂量MRI-CT D_(2cm^(3))同样显著低于CT D_(2cm^(3))(P<0.05)。结论:MRI-CT图像融合技术能更精确地勾画靶区体积以及准确计算放射剂量,不易造成靶区漏照,同时MRI-CT图像融合技术在不同医师间差异较小,可提高靶区勾画的一致性和可靠性,值得在临床推广使用。Objective To explore the effects of MRI-CT image fusion technology on the delineation of cervical tumor target area and dosimetric parameters.Methods The imaging data of 11 patients treated by radiotherapy for cervical tumor were collected.The fusion of MRI and CT images was carried out,and the volume difference and dosimetric difference of the target area delineated based on MRI-CT and CT were compared.The differences in the volume of the target area delineated by different physicians and the dosimetric differences were analyzed.Moreover,intraclass correlation coefficient(ICC)was used for reliability analysis.Results(1)The gross target volume in MRI-CT(GTV_(MRI)-CT)which was delineated by a tumor radiotherapy physician was significantly larger than that of GTV_(CT),and the volume of spinal cord in MRI-CT(Spine_(MRI-CT))was significantly smaller than Spine_(CT)(P<0.05).The volume differences of the target area delineated by 5 tumor radiotherapy physicians had the same trends with the results obtained by a tumor radiotherapy physician.The volume overlapping index of the target area delineated based on different images was 0.83±0.15.(2)For the target areas delineated by 5 tumor radiotherapy physicians,the CV_(MRI-CT) of GTV and spine cord was less than CVCT.ICC was 0.97 and 0.95 for GTV,and 0.83 and 0.82 for spinal cord.(3)The MRI-CT D_(max) of GTV was significantly lower than CT D_(max),and MRI-CT D_(2cm^(3)) of spinal cord was also significantly lower than CT D_(2cm^(3))(P<0.05).Conclusion MRI-CT fusion technology is worthy of clinical promotion for it can achieve the accurate target area delineation and radiation dose calculation,not easy to cause missed exposure of the target area.Meanwhile,there are trivial differences among different doctors in using MRI-CT fusion technology,which improves the consistency and reliability of the target area delineation.

关 键 词：颈椎肿瘤 磁共振成像 计算机断层扫描术 图像融合技术 放射治疗 靶区 

分 类 号：R318[医药卫生—生物医学工程] R738.1[医药卫生—基础医学]