基于实时影像引导对头部伽马刀治疗中误差校正的研究  

Error Correction in Head Gamma Knife Therapy Based on Real-time Image Guidance

作　　者：郭文博 夏玉兵 蔡利红 聂静 GUO Wen-bo;XIA Yu-bing;CAI Li-hong;NIE Jing(Kaifeng Cancer Hospital,Kaifeng 475000,China;Kaifeng Key Laboratory of Radiation Oncology,Kaifeng 475000,China)

机构地区：[1]开封市肿瘤医院,河南开封475000 [2]开封市放射肿瘤学重点实验室,河南开封475000

出　　处：《肿瘤学杂志》2023年第1期42-47,共6页Journal of Chinese Oncology

基　　金：开封市科技攻关项目(2003117)。

摘　　要：[目的]分析实时影像引导放射治疗在头部伽马刀治疗中对误差的控制。[方法]头部伽马刀治疗利用单网热塑膜头架固定患者头部的无创定位方式,结合影像系统监控21例患者49次治疗中的头部位置变化情况,并即时对超过允许误差的位移进行调整。记录治疗过程中每例患者在横向、纵向、竖向3个方向上的误差。[结果]所有患者治疗时横向、纵向、竖向3个方向误差平移阈值≤1 mm。在横向、纵向、竖向3个方向上移床前误差及其总体摆位误差分别为(-0.18±0.44) mm、(-0.04±0.48) mm、(0.11±0.40) mm和(0.72±0.33) mm,相应的校正后摆位误差及其总体摆位误差分别为(-0.16±0.38) mm、(-0.03±0.40) mm、(0.10±0.34) mm、(0.60±0.31) mm。经图像引导校正后,除头脚方向上误差比较差异无统计学意义(P>0.05),在剩余方向误差以及总误差上的差异均有统计学意义(P<0.05),总误差精度有所提高。[结论]实时影像引导放射治疗头部伽马刀与传统头部伽马刀相比,在舒适度和接受度上有明显的优势,其位置精度可控制在立体定向治疗的允许误差范围内,具有实际临床意义。[Objective ] To analyze the error control of real-time image-guide radiation therapy(IGRT) in head gamma knife therapy. [Methods]The non-invasive positioning method of fixing the patient’s head with a single net thermoplastic film headframe combined with the imaging system to monitor the head position changes was used in head gamma knife therapy for 21 patients during49 treatments, and the displacement exceeding the allowable error was immediately adjusted. The errors were recorded in the horizontal, longitudinal and vertical directions during the treatment process. [Results] The translation threshold of the horizontal, longitudinal and vertical errors of all patients during treatment was ≤ 1 mm. The errors in the horizontal, longitudinal and vertical directions before moving the bed and its overall positioning error were(-0.18±0.44) mm,(-0.04±0.48) mm,(0.11±0.40) mm and(0.72±0.33) mm, respectively. The corresponding corrected positioning errors and its overall positioning error were(-0.16±0.38) mm,(-0.03±0.40) mm,(0.10±0.34) mm and(0.60±0.31) mm, respectively. After image guidance correction, there were significant differences in the errors of all directions and the overall error(P<0.05), except in the head and foot directions(P>0.05), and the total position accuracy was improved. [Conclusion] Compared with traditional head gamma knife, real-time IGRT head gamma knife has advantages of comfort and acceptability, and its position accuracy can be controlled within the allowable error range of stereotactic treatment, which has practical clinical significance.

关 键 词：实时影像引导 放射疗法 伽马刀 头部立体定向 

分 类 号：R730.55[医药卫生—肿瘤]