肺癌放疗CBCT与定位CT不同配准模式和不同配准区域的摆位误差分析  

Analysis of Positioning Error between CBCT and CT with Different Registration Modes and Regions in Lung Cancer Radiotherapy

作　　者：管浩然 Guan Haoran(The First Affiliated Hospital of University of Science and Technology of China)

机构地区：[1]安徽省立医院/中国科学技术大学附属第一医院

出　　处：《智慧健康》2025年第5期11-14,共4页Smart Healthcare

摘　　要：目的 探讨不同配准模式及区域对肺癌放疗中锥形束计算机断层扫描(cone-beam computed tomography,CBCT)与定位CT图像配准摆位误差的影响,为临床选择精准配准方法提供依据。方法 选取2023年7月—2024年3月收治的20例肺癌放疗患者,采用“3+1”模式或每次放疗前实施CBCT扫描,共获取132次扫描数据。通过灰度配准、骨配准和手动配准三种模式测量X(左右)、Y(头脚)、Z(前后)方向摆位误差,采用SPSS 27.0进行组间差异性分析。结果 三种配准模式在X/Y/Z三轴的整体误差对比,差异无统计学意义(P>0.05)。Z方向存在显著配准敏感性差异:灰度配准误差(-1.35±1.78)mm显著高于骨配准(-0.90±1.80)mm(P<0.001),骨配准又显著高于手动配准(-0.57±1.76)mm(P=0.002)。Y方向手动配准误差≥3 mm发生率(45.00%)显著高于灰度配准(15.00%)(P=0.041)。结论 Z方向摆位误差对配准模式具有显著敏感性,Y方向手动配准误差风险较高,建议依据解剖特征优选灰度或骨配准模式以提升放疗精度。Objective To evaluate the impact of different registration modes and regions on positioning errors between cone-beam CT (CBCT) and localization CT in lung cancer radiotherapy.Methods 20 patients receiving radiotherapy from July 2023 to March 2024 underwent 132 CBCT scans.Positioning errors in X (lateral),Y (longitudinal),and Z (vertical) directions were measured using grayscale registration,bone registration,and manual registration.Statistical analysis was performed with SPSS 27.0.Results No significant differences were found in overall errors among three registration modes across all axes (P>0.05).Significant sensitivity differences emerged in Z-direction:grayscale registration (-1.35±1.78 mm) showed larger errors than bone registration (-0.90±1.80 mm,P<0.001),which in turn exceeded manual registration (-0.57±1.76 mm,P=0.002).Manual registration had higher incidence of Y-direction errors ≥3 mm (45.00% vs.15.00%,P=0.041).Conclusion Z-direction positioning errors demonstrate significant registration mode sensitivity,while manual registration poses higher Y-direction error risks.Optimal selection of grayscale or bone registration based on anatomical characteristics is recommended to enhance radiotherapy precision.

关 键 词：肺癌 放射治疗 锥形束计算机断层扫描 图像配准 摆位误差 

分 类 号：R734.2[医药卫生—肿瘤]