磁共振成像技术选择对脑转移瘤靶区勾画的影响  

The impact of different magnetic resonance imaging techniques on contouring brain metastases

作　　者：薛青 韩序 胡伟刚 杨昭志 陈佳艳 许青 李懋 凌池芳 XUE Qing;HAN Xu;HU Weigang;YANG Zhaozhi;CHEN Jiayan;XU Qing;LI Mao;LING Chifang(Department of Radiation Oncology,Fudan University Shanghai Cancer Center,Department of Oncology,Shanghai Medical College,Fudan University,Shanghai 200032,China;Department of Radiation Oncology,Philips Healthcare,Chengdu 610000,Sichuan Province,China)

机构地区：[1]复旦大学附属肿瘤医院放疗科,复旦大学上海医学院肿瘤学系,上海200032 [2]飞利浦放射肿瘤事业部,四川成都610000

出　　处：《肿瘤影像学》2022年第4期388-392,共5页Oncoradiology

摘　　要：目的:探讨使用三维快速自旋回波(three-dimensional turbo spin echo,3D TSE)序列和三维反转恢复梯度回波(three-dimensional inversion recovery gradient echo,3D IR-GRE)序列的T1加权增强磁共振图像对勾画脑转移瘤大体肿瘤体积(gross tumor volume,GTV)的影响。方法:分别使用3D TSE序列和3D IR-GRE序列采集9例脑转移瘤患者的T1加权增强图像。1名有多年脑转移瘤治疗经验的放疗科医师在两种序列图像上勾画了GTV。两组GTV的体积差异使用Wilcoxon符号秩和检验,GTV的几何相似度通过统计Dice相似系数评估,GTV的位置差异使用GTV质心偏移评估。结果:9例脑转移瘤患者的磁共振图像上共勾画出47个病灶(体积范围0.02~21.48 mL)。TSE图像上的GTV[(1.583±3.870)mL]大于IR-GRE图像上的GTV[(1.497±3.850 mL,P<0.001)]。两组GTV的Dice相似系数为0.796±0.102,GTV质心偏移为(0.329±0.323)mm。结论:基于TSE序列和IR-GRE序列生成的图像勾画的脑转移瘤GTV的体积和几何范围都有一定差异。考虑TSE序列的造影剂对比度较好,且受磁场不均匀性影响较小,基于该序列勾画的脑转移瘤GTV可能更准确。Objective:To study the effects of three-dimensional turbo spin echo(3D TSE)based and three-dimensional inversionrecovery gradient echo(3D IR-GRE)based T1-weighted enhanced magnetic resonance images on the definition of gross tumor volume(GTV).Methods:T1-weighted enhanced magnetic resonance images of 9 patients with brain metastases were acquired using 3D TSE and 3D IR-GRE respectively.A radiation oncologist with many years of experience in the treatment of brain metastasis contoured the GTVs on both sets of images.The volume difference between the two groups of GTVs were examined using the Wilcoxon signed rank sum test.The geometric agreement of the GTVs was evaluated by the Dice similarity coefficient(DSC).And the location differences of the GTVs were assessed using the center-of-mass distance between the two GTV groups.Results:A total of 47 lesions(volume range 0.02-21.48 mL)were outlined on magnetic resonance images of 9 patients with brain metastases.The mean GTV in TSE images[(1.583±3.870)mL]was larger than that in IR-GRE images[(1.497±3.850)mL,P<0.001].The DSC for the two GTV groups was 0.796±0.102,and the distance between the centers of mass was(0.329±0.323)mm.Conclusion:Volumetric and morphometric differences were found between the two groups of GTVs delineated on TSE and IR-GRE images,respectively.Considering that the TSE sequence offers better contrast enhancement and is less sensitive to the non-uniformity of the magnetic field,the GTV defined based on this sequence may be more accurate.

关 键 词：快速自旋回波序列 反转恢复梯度回波序列 磁共振成像 脑转移瘤 放射治疗 

分 类 号：R739.41[医药卫生—肿瘤] R445.2[医药卫生—临床医学]