| 文婷,黎静,李志强,等.对多发转移病灶在螺旋断层治疗中影像引导方案的评估[J].中华放射医学与防护杂志,2014,34(4):289-291.Wen Ting,Li Jing,Li Zhiqiang,et al.Evaluation of the image guided set-up for multiple metastases treated with tomotherapy[J].Chin J Radiol Med Prot,2014,34(4):289-291 |
| 对多发转移病灶在螺旋断层治疗中影像引导方案的评估 |
| Evaluation of the image guided set-up for multiple metastases treated with tomotherapy |
| 投稿时间：2013-05-21 |
| DOI：10.3760/cma.j.issn.0254-5098.2014.04.013 |
| 中文关键词: 全身多发转移瘤 螺旋断层放疗 图像引导方案 摆位误差 |
| 英文关键词:Multiple metastases Tomotherapy Image guidance Setup errors |
| 基金项目: |
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| 摘要点击次数: 3165 |
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| 中文摘要: |
| 目的 比较在靶区范围内进行一个解剖部位的图像引导与两个解剖部位图像引导两种方案对大范围多发转移病灶放疗精度的影响，为临床选择提供参考。方法 收集50例利用螺旋断层放疗机治疗的靶区长度超过50 cm的多发转移瘤患者的图像数据，将治疗分次内两个部位共计1 220次影像引导数据与定位CT图像进行配准，统计两个部位的摆位误差偏差分布，检验平移误差的一致性，并检验两个部位摆位误差的相关性。 结果 两个部位的摆位误差偏差较大，在左右（x）、头脚（y）、前后（z）方向上的摆位误差大于3 mm的频度分别为34%、46%和28%；大于5 mm的频度分别为10%、16%和8%。x、y、z方向95%一致性限度分别为（9.3，-10.6 ）、（10.5，-11.7）、（7.3，-6.9）mm，均>5 mm界值，表明两个部位的图像配置数据不一致。在x、y、z方向上的摆位误差的R2值分别为0.074、0.475、0.178（P<0.05），在y方向上具有中等程度相关（0.4~0.6）外，x、z方向为弱相关。结论 在对大范围多发转移患者进行摆位误差修正时，建议使用分次内双解剖部位图像引导方案。 |
| 英文摘要: |
| Objective To compare the setup errors between single-site and two-site image guidance in treating multiple metastases using Tomotherapy. Methods A total of 1 220 sets of megavoltage CT (MVCT) images from 50 multiple metastases patients were collected. The setup errors of two anatomic sites were determined by registration of MVCT images with planning images. Bland-Altman plot analysis was used to assess the coincidence of these two methods. Pearson correlation analysis was performed to evaluate the correlation of the setup errors determined by two sets of data and to analyze the deviation values of setup errors.Results The deviation values of setup errors more than 3 mm between two sites were 34%, 46% and 28% in lateral (x), longitudinal (y), vertical (z) directions, respectively. The deviation values of setup errors more than 5 mm were 10%, 16% and 8%,respectively. The Bland-Altman plot analysis showed that the 95% agreement limits of agreement were (9.3, -10.6), (10.5, -11.7), (7.3, -6.9) mm in x, y, z directions, respectively, which were all out of 5 mm tolerance. The Pearson coefficient of correlation along all three directions was less than 0.05, and R2 was 0.074, 0.475, and 0.178 in x, y, z directions, respectively. Conclusions To determine the setup errors for patients with multiple metastases, single-site image guidance method is not consistent, and the two site image guidance method would be recommended. |
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