扇形束CT引导头颈部肿瘤放疗的智能摆位与人眼摆位精度比较  

Comparison of set-up errors between human positioning and AI positioning guided by fan-beam CT in radiotherapy for head and neck tumors

作　　者：朱丽婷 刘守鸿 郭嘉俊 王孝深 ZHU Liting;LIU Shouhong;GUO Jiajun;WANG Xiaoshen(Department of Radiotherapy,Eye&ENT Hospital,Fudan University,Shanghai 200031,China)

机构地区：[1]复旦大学附属眼耳鼻喉科医院放疗科,上海200031

出　　处：《中国眼耳鼻喉科杂志》2024年第5期418-422,共5页Chinese Journal of Ophthalmology and Otorhinolaryngology

摘　　要：目的比较扇形束CT(FBCT)引导校正下机器参与的一键智能摆位与传统人眼摆位精度的差异,并评估一键智能摆位在头颈部肿瘤放射治疗(简称放疗)各阶段的应用效果。方法针对在联影uRT-linac506c加速器上接受放疗的头颈部肿瘤患者,常规采用扇形束CT引导的放疗(FBCT-RT),频率如下:前3次均FBCT-RT,之后每周1次FBCT-RT。分析患者三维方向的摆位误差。试验组于第2次FBCT-RT采用经FBCT校准后的一键智能摆位功能不进行人眼校准。对照组于第3次FBCT-RT采用人眼摆位。利用自身配对t检验比较2组间摆位时间和摆位误差。利用方差分析比较应用一键智能摆位功能下患者放疗第1~6周的每周摆位误差。2022年9月—2022年11月共有35例头颈部肿瘤患者进入研究。结果2组间垂直方向(VRT)、头脚方向(LNG)和左右方向(LAT)摆位误差总体均数的差异均有统计学意义(P<0.05)。并且一键智能摆位能将放疗前3周的摆位误差控制相对稳定,前3周间的三维摆位误差差异无统计学意义(P>0.05),恶性肿瘤后3周VRT则会出现个体化差异(P<0.05),但眼眶良性肿瘤的摆位在三维方向均维持稳定。结论基于FBCT引导下应用一键智能摆位后能减小头颈部肿瘤患者放疗前期摆位误差,节省摆位时间,对眼眶良性肿瘤应用效果最好。Objective To compare the differences in set-up errors between human eye positioning and artificial intelligence(AI)positioning guided by fan-beam CT(FBCT)during radiotherapy for head and neck tumors(HNT).Methods FBCT guided radiotherapy(FBCT-RT)was routinely used for HNT treatment on uRT-linac 506c accelerator.FBCT scans were carried out at specific intervals,including the first three fractions and then once a week.The set-up errors were analyzed in three dimensions.The second FBCT scan was performed using only AI positioning without visual calibration(experimental group),while the third FBCT scan was implemented using human positioning(control group).Self-compared t-test was used to compare the set-up errors and positioning time of the two groups.Analysis of variance was used to compare the set-up errors under AI positioning during the six-week course of radiotherapy.Thirty-five HNT patients were enrolled in the study from September 2022 to November 2022.Results The set-up errors in vertical direction(VRT),longitudinal direction(LNG)and lateral direction(LAT)direction were all statistically significant(P<0.05)between the two groups.It was found that set-up errors could be stably controlled with AI positioning during the first three weeks of radiotherapy for all patients.However,instability of VRT occurred during the last three weeks of radiotherapy for malignancies(P<0.05),althrough set-up accuracy remained stable for orbital tumors.Conclusions AI positioning guided by FBCT not only saved set-up time but also reduced set-up errors during earlier stages of radiotherapy.Compared with other HNTs,orbital benign tumors benefited most from AI positioning due to lower set-up errors.lower set-up errors.

关 键 词：头颈肿瘤 智能摆位 摆位误差 扇形束CT引导放疗 

分 类 号：R766[医药卫生—耳鼻咽喉科]