| 李奉祥,李建彬,张英杰,等.基于3D-CT与4D-CT定义的非小细胞肺癌计划靶区比较[J].中华放射医学与防护杂志,2011,31(2):200-203.LI Feng-xiang,LI Jian-bin,ZHANG Ying-jie,et al.Comparison of planning target volumes based on three-dimensional CT and four-dimensional CT simulation images of non-small-cell lung cancer[J].Chin J Radiol Med Prot,2011,31(2):200-203 |
| 基于3D-CT与4D-CT定义的非小细胞肺癌计划靶区比较 |
| Comparison of planning target volumes based on three-dimensional CT and four-dimensional CT simulation images of non-small-cell lung cancer |
| 投稿时间：2010-07-14 |
| DOI：10.3760/cma.j.issn.0254-5098.2011.02.022 |
| 中文关键词: 非小细胞肺癌 三维CT模拟定位 四维CT模拟定位 计划靶区 比较 |
| 英文关键词:Non-small-cell lung cancer Three-dimensional CT simulation Four-dimensional CT simulation Planning target volume Comparison |
| 基金项目:山东省自然科学基金(Y2007C100);山东省科技发展计划项目(2007GG3WZ02047) |
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| 中文摘要: |
| 目的 探讨基于3D-CT轴位扫描所定义的计划靶区(PTVvector)与基于4D-CT定义的计划靶区(PTV4D)的位置和体积差异。方法 适合三维适形放疗(3D-CRT)的非小细胞肺癌(NSCLC)患者共28例,其中,16例肿瘤位于肺上叶为肺上叶组,12例肿瘤位于肺中下叶为肺中下叶组,均于同次CT模拟定位时序贯完成胸部常规3D-CT轴位扫描和4D-CT扫描。基于3D-CT图像GTV及其运动矢量定义PTVvector:GTV外扩7 mm形成CTV,在CTV基础上依据4D-CT测得的肿瘤三维运动矢量均匀外扩形成ITVvector,然后再外扩3 mm,形成PTVvector;基于4D-CT图像各时相GTV融合定义PTV4D:10个时相的GTV分别外扩7 mm形成各时相的CTV,10个时相的CTV融合形成ITV4D,ITV4D外扩3 mm形成PTV4D。对比PTVvector和PTV4D靶区位置、体积及包含度差异,分析三维运动矢量和相关参数的相关性。结果 肺上叶和肺中下叶两组肿瘤中心三维运动矢量中位数分别为2.8和7.0 mm,差异有统计学意义(z=-3.485,P<0.05)。 肺上叶组PTVvector和PTV4D中心点坐标仅在x轴上差异有统计学意义(z=-2.010,P<0.05),肺中下叶组两靶区中心点坐标仅在z轴上差异有统计学意义(z=-2.136,P< 0.05)。肺上叶组PTV4D与PTVvector比值的中位数为0.75,肺中下叶组为0.52,两比值与肿瘤三维运动矢量的相关性差异均有统计学意义(r=-0.638、-0.850,P<0.05)。PTVvector与PTV4D彼此间包含度的中位数分别为66.39%和99.55%,两者与肿瘤的三维运动矢量相关性差异有统计学意义(r=-0.814、0.613,P<0.05)。 结论 基于4D-CT定义的PTV4D明显小于基于3D-CT定义的PTVvector,两者的比值及相互包含度均与肿瘤三维运动矢量显著相关。 |
| 英文摘要: |
| Objective To compare the positional and volumetric differences of planning target volumes (PTVs) based on axial three-dimensional CT (3D-CT) and four-dimensional CT (4D-CT) for the primary tumor of non-small cell lung cancer (NSCLC). Methods Sixteen NSCLC patients with lesions located in the upper lobe and 12 patients with lesions in middle and lower lobes, totally 28 patients, initially underwent three-dimensional CT scans followed by 4D-CT scans of the thorax under normal free breathing. PTVvector was defined on gross tumor volume (GTV) contoured on 3D-CT and its motion vector. The clinical target volumes (CTVs) were created by adding 7 mm to GTVs, then, internal target volume (ITVs) were produced by enlarging CTVs isotropically based on the individually measured amount of motion in the 4D-CT, lastly, PTVs were created by adding 3 mm setup margin to ITVs. PTV4D was defined on the fusion of CTVs on all phases of the 4D data. The CTV was generated by adding 7 mm to the GTV on each phase, then, PTVs were produced by fusing CTVs on 10 phases and adding 3 mm setup margin. The position of the target center, the volume of target and the degree of inclusion (DI) were compared reciprocally between the PTVvector and the PTV4D. The difference of the position, volume and degree of inclusion of the targets between PTVvector and PTV4D were compared, and the relevance between the relative characters of the targets and the three-dimensional vector was analyzed based on the groups of the patients. Results The median of the 3D motion vector for the lesions in the upper lobe was 2.8 mm, significantly lower than that for the lesions in the middle and lower lobe (7.0 mm, z=-3.485,P < 0.05). In the upper lobe group there was only significant spatial difference between the PTVvector and PTV4D targets in the center coordinate at the x axe (z=-2.010,P <0.05), while in the middle and lower lobes there was only significant spatial difference between the PTVvector and PTV4D targets in the center coordinates at the z axe (z=-2.136,P<0.05). The median of ratio of PTV4D and PTVvector of the upper lobe group was 0.75, significantly higher than that of the middle and lower lobes group (0.52, z=-2.949,P < 0.05). A significant correlation was found for the motion vector and the ratio of PTVvector and PTV4D in both groups (r=-0.638,-0.850,P< 0.05). For all patients, the median of DI of PTV4D in PTVvector was 66.39%, while the median of DI of PTVvector in PTV4D was 99.55%, both showed a positive significant correlation with the motion vector (r=-0.814,0.613,P < 0.05). Conclusions PTV4D defined based on 4D-CT simulation images is obviously less than PTVvector defined based on 3D-CT simulation images. The ratio and DI of both targets are related with the three-dimensional motion vector of the tumor. |
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