四维CT在肺部肿瘤内靶区勾画方法中的差异性研究  

Study on differences in target delineation methods for lung tumors using on four-dimensional CT

作　　者：张梦雨 段诗苗[1] 吴烨 郭子文 李伟 江浩[1] ZHANG Mengyu;DUAN Shimiao;WU Ye;GUO Ziwen;LI Wei;JIANG Hao(Department of Radiotherapy,the First Affiliated Hospital of Bengbu Medical College,Bengbu,Anhui 233004,China;不详)

机构地区：[1]蚌埠医学院第一附属医院放疗科,安徽蚌埠233004 [2]安徽省呼吸系统疾病(肿瘤)临床医学研究中心,安徽蚌埠233004

出　　处：《中华全科医学》2023年第8期1315-1318,共4页Chinese Journal of General Practice

基　　金：2021年第二批安徽省中央引导地方科技发展资金项目(2020b07030008);蚌埠医学院自然科学重点项目(BYKY2019077ZD)。

摘　　要：目的基于不同部位的肺部肿瘤患者四维CT(4DCT)图像,比较采用哪种靶区勾画方法更高效。方法选择2019年10月-2021年12月于蚌埠医学院第一附属医院行4DCT模拟定位扫描的130例肺部肿瘤患者。医生在4DCT的10个时相进行大体肿瘤体积(GTV)靶区勾画,融合得到IGTV_(10);基于最大密度投影(MIP)、平均密度投影(AIP)、4DCT的0%和50%时相图像勾画得到IGTV_(MIP)、IGTV_(AIP)、IGTV_(2)。从体积和质心位移对上述靶区勾画方法进行差异对比。结果肺上叶组IGTV_(MIP)、IGTV_(AIP)、IGTV_(2)对IGTV_(10)比值分别为1.00、0.98、0.99(P=0.143,<0.001,<0.001),肺中下叶组比值分别为0.99、0.96、0.98(P=0.603,<0.001,<0.001)。肺上叶组IGTV_(10)与IGTV_(MIP)相互包含度差异无统计学意义(P>0.05),IGTV_(10)与IGTV_(AIP)、IGTV_(2)相互包含度差异有统计学意义(均P<0.05),肺中下叶组IGTV_(10)与IGTV_(MIP)、IGTV_(AIP)、IGTV_(2)相互包含度差异有统计学意义(均P<0.05)。结论10个时相融合的图像所包含的运动信息明显大于AIP图像和0%+50%时相融合的图像,但接近于MIP图像,在使用MIP图像勾画靶区时也要考虑肿瘤所在位置。Objective Based on four dimensional CT(4DCT)images of patients with lung tumors in different parts,the study compares which target delineation method is more efficient.Methods A total of 130 patients with lung tumors,who underwent 4DCT simulation scans at the First Affiliated Hospital of Bengbu Medical College from October 2019 to December 2021 were selected.The doctor delineated the gross tumor volume(GTV)targets in 10 phases of 4DCT,and IGTV_(10) was obtained by fusion.IGTV_(MIP),IGTV_(AIP)and IGTV_(2)were obtained based on maximum density projection(MIP),average density projection(AIP)images,0%and 50%time-phase of 4DCT.The above delineation methods were compared in terms of volume and centroid displacement.Results The ratios of IGTV_(MIP),IGTV_(AIP)and IGTV_(2)to IGTV_(10) in the upper lobe group were 1.00,0.98 and 0.99,respectively(P=0.143,<0.001,<0.001).The ratios for the middle and lower lobe groups were 0.99,0.96 and 0.98,respectively(P=0.603,<0.001,<0.001).There was no significant difference in the degree of mutual inclusion between IGTV_(10) and IGTV_(MIP)in the upper lung lobe group(P>0.05),while there was a significant difference in the degree of mutual inclusion between IGTV_(10),IGTV_(AIP)and IGTV_(2)in the upper lung lobe group(all P<0.05).The degree of mutual inclusion of IGTV_(10),IGTV_(MIP),IGTV_(AIP)and IGTV_(2)in the middle and lower lung lobe group was significantly different(all P<0.05).Conclusion The motion information contained in the 10 time-fused images is significantly greater than that of the AIP images and the 0%+50%fused images,but close to that of the MIP images.The location of the tumor should also be considered when using MIP images to delineate the target area.

关 键 词：肺部肿瘤 四维计算机断层扫描 内在大体肿瘤靶体积 最大密度投影 平均密度投影 

分 类 号：R734.2[医药卫生—肿瘤] R730.4[医药卫生—临床医学]