不同图像引导系统在宫颈癌放射治疗摆位误差和靶区外放中的对比研究  

Comparative study of different image-guided systems in positioning error and placement outside the target area of radiotherapy for cervical cancer

作　　者：刘莉 叶程伟 袁建军[1] 罗银贵 罗志尧 曾伟 李羚[1] 刘欢 刘艳[1] 何淼[1] Liu li;Ye Chengwei;Yuan Jianjun;Luo Yingui;Luo Zhiyao;Zeng Wei;Li Ling;Liu Huan;Liu Yan;He Miao(Department of Oncology,Deyang People's Hospital,Deyang 618000,China)

机构地区：[1]德阳市人民医院肿瘤科,德阳618000

出　　处：《中国医学装备》2025年第4期18-22,共5页China Medical Equipment

摘　　要：目的:对比分析Halcyon与Synergy两种不同图像引导系统在宫颈癌放射治疗摆位误差和靶区外放的差异。方法:选取2023年3月至6月在德阳市人民医院治疗的40例宫颈癌患者资料,分别采用Halcyon直线加速器和Synergy直线加速器进行治疗,每种治疗方法20例患者。所有患者放射治疗前均使用千伏级锥形束CT(kV-CBCT)进行图像扫描,将获取的CBCT图像与定位CT图像进行图像在线匹配,分别得到左右(x)、头脚(y)和前后(z)3个平移方向以及旋转方向的俯仰(Rx)、旋转(Ry)和偏转(Rz)方向上的配准结果,根据摆位外扩公式计算计划靶体积外扩边界(MPTV)值,对比分析Halcyon与Synergy图像引导系统的摆位误差和靶区外放差异。结果:Halcyon和Synergy图像引导系统分别获取到479和447组CBCT图像,Halcyon图像引导系统x、y和z方向平移误差分别为(-0.03±0.21)、(0.12±0.63)和(0.02±0.15)cm,Rx、Ry和Rz方向旋转误差分别为(0.38±1.26)°、(-0.40±1.02)°和(0.07±1.07)°;Synergy图像引导系统x、y和z 3个方向的平移误差分别为(-0.07±0.18)、(0.08±0.49)和(0.11±0.22)cm,Rx、Ry和Rz方向旋转误差分别为(0.28±1.29)°、(-0.29±1.29)°和(-0.16±1.20)°,两个图像引导系统在y方向上平移误差值大于x和z方向,平移误差的绝对值基本集中在5 mm范围内。Halcyon与Synergy图像引导系统在Rx、Ry方向上旋转摆位误差的差异无统计学意义(P>0.05),在Rz方向上旋转摆位误差的差异有统计学意义(t=-3.06,P<0.05)。Halcyon图像引导系统在x、y和z方向的MPTV值分别为0.4、1.4和0.3 cm,Synergy图像引导系统分别为0.4、0.9和0.5 cm,Halcyon图像引导系统在y方向上靶区外扩边界大于Synergy图像引导系统,其他方向均≤0.5 cm。结论:Halcyon和Synergy图像引导系统的MPTV值均能满足宫颈癌临床放射治疗要求,Halcyon图像引导系统的摆位误差大于Synergy图像引导系统,但扫描时间和治疗时间明显低于Synergy图像引导系统,�Objective:To compare and analyze the differences in positioning errors and placement outside the target area between two different image-guided systems(Halcyon and Synergy)in radiotherapy for cervical cancer.Methods:The data of 40 patients with cervical cancer who received treatment in Dezhou People's Hospital from March 2023 to June 2023 were retrospectively selected.Each patient was treated respectively with Halcyon linear accelerator and Synergy linear accelerator,with 20 cases for each treatment method.All patients underwent cone beam computed tomography(CBCT)at kV level to conduct image scanning before radiotherapy,and the obtained CBCT images were matched with the positioned CT images by online.The registration results of left and right(x),head and foot(y)and front and back(z)of three translation direction,and pitch(Rx),rotation(Ry)and deflection(Rz)directions of rotation direction were respectively obtained.The margin of planning target volume(MPTV)was calculated according to positioning expansion formula.The differences of positioning errors and target area expansion between Halcyon and Synergy image-guided systems were compared and analyzed.Results:Halcyon and Synergy image-guided systems obtained respectively 479 and 447 sets of CBCT images.The translational errors of Halcyon image-guided system on x,y,and z directions were respectively(-0.03±0.21),(0.12±0.63)and(0.02±0.15)cm,and the rotational errors of that on Rx,Ry and Rz directions were respectively(0.38±1.26)°,(-0.40±1.02)°,and(0.07±1.07)°.The translational errors of Synergy image-guided system were respectively(-0.07±0.18),(0.08±0.49)and(0.11±0.22)cm on the three directions,and the rotational errors of that were respectively(0.28±1.29)°,(-0.29±1.29)°and(-0.16±1.20)°.The translational error values on the y direction of both image-guided system were larger than that on x and z directions,and the absolute values of the range of translational errors of them were basically within 5 mm.There were no statistically significant difference

关 键 词：宫颈癌 图像引导 Halcyon医用直线加速器 Synergy医用直线加速器 摆位误差 

分 类 号：R144[医药卫生—公共卫生与预防医学] R737.33