| 陈进琥,李宝生,卢洁,尹勇,王中堂,董晓玲.肺SPECT显像在肺癌放疗中保护肺功能的应用[J].中华放射医学与防护杂志,2008,28(6):646-649 |
| 肺SPECT显像在肺癌放疗中保护肺功能的应用 |
| Applying SPECT to protection of lung function for lung cancer patients with radiotherapy |
| 投稿时间：2007-11-21 |
| DOI： |
| 中文关键词: 肺肿瘤/放射疗法 断层摄影术,单光子发射型计算机 图像融合 计划优化 |
| 英文关键词:Lung neoplasms/radiotherapy Tomography,single-photon emission computed Image fusion Plan optimization |
| 基金项目:山东省科技攻关计划(2006GG2202012) |
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| 中文摘要: |
| 目的 研究肺癌放疗计划制定中结合肺单光子发射型计算机断层摄影术(SPECT)图像有效保护放疗中功能肺的可行性。方法 选取11例肺癌患者先行CT模拟定位,后在相同体位下行肺SPECT显像检查。利用治疗计划系统将CT图像与SPECT图像融合,通过融合图像在CT图像上勾画出功能肺。分别设置优化参数制定两种计划(T1和T2)进行比较。T1不考虑肺功能分布,T2充分考虑肺功能分布并尽可能降低功能肺受照剂量。脊髓、心脏等器官分别设置限制参数。肺癌病灶放疗2 Gy/次,总剂量66 Gy。结果 在保证计划靶体积达处方剂量且无差别及脊髓最大剂量小于45 Gy前提下,T1计划的功能肺受照体积V5、V10、V20分别为(63.45±4.20)%、(48.45±3.87)%、(22.66±2.01)%,T2计划的分别为(61.51±4.05)%、(40.93±3.23)%、(19.45±1.74)%,与T1相比较明显下降(P<0.05)。T1计划的功能肺V30、V40、V50分别为(13.34±1.67)%、(7.83±1.18)%、(4.14±0.68)%,T2计划的分别为(12.69±1.54)%、(8.10±1.30)%、(4.53±0.82)%,与T1相比较无明显下降(P>0.05)。结论 结合肺SPECT图像制定肺癌放疗计划能降低功能肺受照剂量,由此可减少并发症、改善患者生活质量。 |
| 英文摘要: |
| Objective To study on the feasibility of making radiotherapy plan for lung cancer patients combined with single-photon emission computed tomography (SPECT) images to effectively protect the functional lung.Methods Eleven lung cancer patients were selected and carried out with SPECT under the same body posture after CT simulation. The images of SPECT and CT were fused with treatment planning system (TPS), and the outline of the functional-lung on CT image by fusion image was drawn. Through application of TPS, optimized parameters were setup to compare two plans (T1 and T2). The distribution of lung function was not considered in T1 plan, while it was fully considerd in T2 plan to reduc the exposure dose on functional lung by all means. The restricted parameters were set respectively on spinal cord, heart and other organs. Radiotherapy total doses were 60 Gy with 2 Gy per fractionation.Results On the premise of ensuring the prescription dose up to par for planning target volume (PTV) also which no difference and/or spinal cord maximal dose <45 Gy, the volumes under 5 Gy, 10 Gy and 20 Gy (V5, V10 and V20) of functional-lung reduced in T2 plan (P<0.05), there were (63.45±4.20)%、(48.45±3.87)%、(22.66±2.01)% in T1 plan, and (61.51±4.05)%、(40.93±3.23)%、(19.45±1.74)% in T2 plan, respectively. But the V30, V40 and V50 did not go down (P>0.05), there were (13.34±1.67)%、(7.83±1.18)%、(4.14±0.68)% in T1 plan and (12.69±1.54)%、(8.10±1.30)%、(4.53±0.82)% in T2 plan, respectively.Conclusion It can effectively reduce the radiation dose on functional lung, decrease complications, and improve living quality of the lung cancer patients at plan optimization combined with SPECT images. |
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