CBCT引导下对三维治疗床与六维治疗床配准放疗摆位误差的研究  

Analysis of Setup Errors in Radiotherapy Between Three-Dimensional Treatment Couch and Six-Dimensional Treatment Couch Registration by Cone Beam CT Image

作　　者：易良波 岳海振[2] 李俊禹 胡鉴颀 陈吉祥[2] 毛继 卢子红 王钦 YI Liangbo;YUE Haizhen;LI Junyu;HU Jianqi;CHEN Jixiang;MAO Ji;LU Zihong;WANG Qin(Department of Radiation Oncology,Shifang People’s Hospital,Deyang Sichuan 618400,China;Department of Radiotherapy,Beijing Cancer Hospital&Beijing Institute for Cancer Research,Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education/Beijing),Beijing 100142,China;Department of Radiotherapy,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China)

机构地区：[1]什邡市人民医院肿瘤科放疗室,四川德阳618400 [2]北京大学肿瘤医院暨北京市肿瘤防治研究所(放疗科)/恶性肿瘤发病机制及转化研究教育部重点实验室,北京100142 [3]首都医科大学附属北京世纪坛医院放疗科,北京100038

出　　处：《中国医疗设备》2024年第4期47-52,共6页China Medical Devices

基　　金：北京市自然科学基金(1202009);德阳市科技计划项目(2023SZZ094)。

摘　　要：目的利用锥形束CT图像引导三维放射治疗床与六维放射治疗床配准精度,并分析其放疗摆位误差,为临床使用三维放射治疗床的放疗流程管理提供参考。方法选取50例鼻咽癌患者、49例食管癌患者和25例直肠癌患者治疗前的锥形束CT图像为研究对象,在离线配准下设置相同的感兴趣区域,分别选择三维放射治疗床的线性方向和六维放射治疗床的线性与旋转方向进行骨性配准,分析配准后产生的摆位误差。结果鼻咽癌与直肠癌患者分别采用秩和检验与方差齐性独立样本检验,升降(Vertical,Vrt)方向与左右(Lateral,Lat)方向差异均有统计学意义(P<0.05),进出(Longitudinal,Lng)方向差异无统计学意义(P>0.05);食管癌患者采用秩和检验,Vrt方向上差异有统计学意义(P<0.05),在Lng和Lat方向上差异均无统计学意义(P>0.05)。3个部位的Lng方向上差异均无统计学意义(P>0.05)。鼻咽癌、直肠癌、食管癌3种病例患者在线性方向的容差值分别为3、5、5 mm时,其中2、4、4 mm容差范围的数量占比较大;在平移方向,2种配准方式的摆位误差基本都在临床设定值的范围内。六维配准显示,鼻咽癌患者的头脚旋转方向与食管癌和直肠癌患者3个旋转方向的摆位误差较大。结论三维放射治疗床配准时反馈的摆位误差信息量低于六维放射治疗床,使用三维放射治疗床摆位时需加强放疗全流程与旋转方向摆位技术管理,提高放疗摆位效率与放疗增益比。Objective To analyze the setup error of radiotherapy by using the registration accuracy of cone beam CT image-guided three-dimensional and six-dimensional radiotherapy couch,and to provide reference for the management of radiotherapy process using three-dimensional radiotherapy couch in clinical practice.Methods The cone beam CT images of 50 patients with nasopharyngeal carcinoma,49 patients with esophageal cancer,and 25 patients with rectal cancer before radiotherapy were selected as the research objects.The same region of interest was set using offline registration.Rigid registration was performed separately in the linear direction of the three-dimensional radiotherapy couch and the linear and rotational directions of the six-dimensional radiotherapy couch.The resulting setup errors after registration were analyzed.Results There was a significant difference in both the vertical(Vrt)and lateral(Lat)directions(P<0.05)in patients with nasopharyngeal carcinoma using rank sum test while rectal cancer using independent sample test for homogeneity of variance,but there was no significant difference in longitudinal(Lng)direction(P>0.05).Rank-sum test was conducted on patients with esophageal cancer.There was a statistically significant difference(P<0.05)in the Vrt direction,but no significant difference(P>0.05)was found in the Lng and Lat directions.There was no significant difference(P>0.05)in the Lng direction across all three sites.For patients with nasopharyngeal cancer,rectal cancer,and esophageal cancer,when the tolerance values in the linear direction were 3,5,and 5 mm,respectively,the quantities of tolerance ranges of 2,4,and 4 mm accounted for a significant proportion.In the translation direction,the setup errors for both registration methods were basically within the clinically set range.With six-dimensional registration,it was observed that there were larger setup errors in the head-to-foot direction for patients with nasopharyngeal cancer compared to the three rotational directions for patients with esophag

关 键 词：CBCT图像配准 摆位误差 三维治疗床 六维治疗床 

分 类 号：R144[医药卫生—公共卫生与预防医学]