CBCT、EPID图像引导在肿瘤放疗中的应用研究  

Study on the Application of CBCT and EPID in Tumor Radiotherapy

作　　者：黄焱秋[1] 郭斌 黄滈骢 周春骏[1] 余忠全[1] 陈少卿[1] HUANG Yanqiu;GUO Bin;HUANG Haocong(The First Affiliated Hospital of Nanchang University,Nanchang,330006)

机构地区：[1]南昌大学第一附属医院,330006 [2]江西中医药大学第二附属医院,330012 [3]井冈山大学医学部,343009

出　　处：《实用癌症杂志》2023年第11期1843-1846,1850,共5页The Practical Journal of Cancer

基　　金：江西省卫健委资助课题(编号:20203117)。

摘　　要：目的 研究分析CBCT和EPID两种图像引导技术对肿瘤放疗位置误差验证的差异。方法 将放疗患者根据肿瘤部位分为头颈部和体部2组,利用Varian Vitalbeam机载图像引导系统(OBI)提供的电子射野影像系统(electronic Dortal imaging device,EPID)和千伏级锥形束CT (cone beam computed tomography,CBCT),于患者每次治疗前先采集EPID(KV-MV)图像进行自动配准检测并记录在六维方向(vrt、lng、lat、rtn、roll、pitch)及各阈值区间的位置误差数据。在不纠正KV-MV检测的位置误差的情况下再次采集CBCT图像进行自动配准手动修正检测并记录和KV-MV(EPID)相同项目的位置误差数据。根据两种技术检测到的位置误差数据,分析比较两种图像引导技术在不同部位的肿瘤和六维各方向及误差阈值之间数据的差异性。结果 头颈组CBCT和EPID两种图像引导方式各获取252人次六维方向1512个误差数据。在六维Pitch方向及误差阈值≤1°和>1°之间对放疗位置误差验证具有统计学差异(P<0.05),在六维其它方向及各误差阈值之间,CBCT和EPID两种引导方式对放疗位置误差验证没有统计学差异(P>0.05)。体部组CBCT和EPID两种图像引导方式各获取186人次六维方向1116个误差数据。在六维方向及各误差阈值之间,CBCT和EPID两种图像引导方式对放疗位置误差验证没有统计学差异(P>0.05)。结论 CBCT和EPID两种图像引导技术均能较好满足精准放疗的临床需求,CBCT引导在图像分辨率和六维旋转验证上具有优势。Objective To study and analyze the difference between CBCT and EPID image guided techniques in position error verification of tumor radiotherapy.Methods Radiotherapy patients were divided into head and neck groups and body groups according to tumor sites.The electronic Dortal imaging device provided by Varian Vitalbeam image guidance system(OBI)was used.EPID and kilovoltage cone beam computed tomography,Before each treatment,EPID(KV-MV)images were collected for automatic registration,and the position error data in 6 directions(vrt,lng,lat,rtn,roll,pitch)and each threshold interval were recorded.Without correcting the position errors detected by KV-MV,CBCT images were collected again for automatic registration manual correction detection,and the position error data of the same items as KV-MV(EPID)were recorded.According to the position error data detected by the 2 techniques,the differences between the 2 image guidance techniques in different parts of the tumor and the 6 dimensional directions and the error threshold data were analyzed and compared.Results In the head and neck group,1512 error data were obtained from 252 patients in 6 dimensional direction by CBCT and EPID respectively.In the 6-dimensional Pitch direction and error threshold≤1°and>1°,there were statistical differences in the validation of radiotherapy position error(P<0.05).In the other 6-dimensional directions and error threshold there were no statistical differences in the validation of radiotherapy position error between CBCT and EPID guidance methods(P>0.05).In the body group,1116 error data were obtained from 186 patients in the six-dimensional direction by CBCT and EPID respectively.There was no statistical difference between CBCT and EPID in the verification of radiotherapy position error in the 6-dimensional direction and each error threshold(P>0.05).Conclusion CBCT and EPID can better meet the clinical requirements of precision radiotherapy.CBCT guidance has advantages in image resolution and 6-dimensional rotation verification.

关 键 词：CBCT EPID 图像引导 放射治疗 误差 

分 类 号：R730.55[医药卫生—肿瘤]