光学表面监测系统容积漫游技术体表影像在胸部肿瘤调强放疗中的应用价值  

Application value of optical surface monitoring system volume rendering technique body surface imaging in intensity-modulated radiotherapy for thoracic tumors

作　　者：肖志平 李定宇 付秀根 李君超 刘琪 钟伟伟 Xiao Zhiping;Li Dingyu;Fu Xiugen;Li Junchao;Liu Qi;Zhong Weiwei(Department of Oncology,Tongji Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院肿瘤科,武汉430030

出　　处：《肿瘤研究与临床》2024年第1期47-51,共5页Cancer Research and Clinic

摘　　要：目的探讨光学表面监测系统(OSMS)容积漫游技术(VRT)体表影像在胸部肿瘤调强放疗中的应用价值。方法回顾性病例系列研究。回顾性分析2021年9月至2022年10月华中科技大学同济医学院附属同济医院收治的65例行调强放疗的胸部肿瘤患者的临床资料。患者首次治疗行锥形束CT(CBCT)扫描并校正后利用OSMS获取VRT体表影像,后续治疗以VRT影像为基准,利用OSMS的六维床自动移动功能摆位,记录六维方向移床值,再行CBCT扫描并记录左右方向(X轴)、头脚方向(Y轴)和腹背方向(Z轴)平移误差和旋转误差。六维自动移床校正后,再记录此时的医学数字成像和通信(DICOM)体表影像实时δ(RTD)值,并获取新的VRT影像。CBCT配准误差值为VRT影像引导摆位误差,CBCT配准误差值与移床移动值之和为体表标记线引导摆位误差,CBCT配准误差值与记录的DICOM影像的RTD值之和为DICOM影像引导摆位的理论误差。对比分析VRT影像与体表标记线、DICOM影像引导摆位的优劣。结果65例患者包括男性42例,女性23例;年龄[M(Q 1,Q 3)]58岁(51岁,64岁)。VRT影像引导摆位在X、Y、Z轴上的线性误差[M(Q 1,Q 3)]分别为0.6 mm(0.3 mm,1.2 mm)、1.2 mm(0.5 mm,2.4 mm)、1.1 mm(0.5 mm,1.9 mm),旋转误差分别为0.4°(0.1°,0.7°)、0.4°(0.1°,0.6°)、0.4°(0.2°,0.6°);标记线引导摆位的线性误差分别为1.6 mm(0.9 mm,2.6 mm)、2.2 mm(1.1 mm,3.8 mm)、1.0 mm(0.4 mm,1.8 mm),旋转误差分别为0.7°(0.3°,1.2°)、0.5°(0.2°,0.8°)、0.5°(0.2°,0.8°);DICOM影像引导摆位的线性误差分别为1.1 mm(0.6 mm,1.9 mm)、2.1 mm(1.0 mm,3.4 mm)、1.3 mm(0.6 mm,3.1 mm),旋转误差分别为0.6°(0.2°,1.1°)、0.7°(0.3°,1.1°)、0.7°(0.2°,1.1°)。与标记线引导摆位相比,除Z轴线性误差(P=0.218)外,VRT影像引导摆位其余误差均低(均P<0.001);与DICOM影像引导摆位比较,VRT影像引导摆位X、Y、Z轴线性误差和旋转误差均低(均P<0.01)。结论VRT影像引导摆位优�Objective To explore the application value of optical surface monitoring system(OSMS)volume rendering technique(VRT)body surface imaging in intensity-modulated radiotherapy for thoracic tumors.Methods A retrospective case series study was performed.The clinical data of 65 patients with thoracic tumors treated with intensity-modulated radiotherapy at Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from September 2021 to October 2022 were retrospectively analyzed.In the first treatment,after cone-beam computed tomography(CBCT)scan and correction,VRT body surface images were obtained by using OSMS.In subsequent treatment,the VRT image was used as the benchmark and the 6-dimensional bed was automatically positioned to record the 6-dimensional bed positioning value.The CBCT scan was performed to record the translation and rotation errors of left-right direction(X-axis),head-foot direction(Y-axis)and front-rear direction(Z-axis).After the calibration of the 6-dimensional automatic bed shifting,the new real-time deltas(RTD)value of digital imaging and communications in medicine(DICOM)body surface image was recorded,and the new VRT image was obtained.CBCT registration error value was defined as VRT image-guided setup error.The sum of CBCT registration error value and moving bed movement value was defined as the body surface marker line-guided setup error.The sum of CBCT registration error value and the recorded DICOM image RTD value was defined as the theoretical error of DICOM image-guided setup.The advantages and disadvantages of VRT image,body surface marker line and DICOM image-guided setup were compared and analyzed.Results There were 42 males and 23 females in 65 patients with thoracic tumors,and the age[M(Q 1,Q 3)]was 58 years(51 years,64 years).The linear errors[M(Q 1,Q 3)]of VRT image-guided setup in X,Y and Z axes were 0.6 mm(0.3 mm,1.2 mm),1.2 mm(0.5 mm,2.4 mm)and 1.1 mm(0.5 mm,1.9 mm);and the rotational errors were 0.4°(0.1°,0.7°),0.4°(0.1°,0.6°)and

关 键 词：胸部肿瘤 锥束计算机体层摄影术 图像处理 计算机辅助 放射治疗 图像引导 放射治疗摆位误差 容积漫游技术 

分 类 号：R730.55[医药卫生—肿瘤]