| 胡超月,李建彬,王金之,王玮,李奉祥,郭延娈.基于增强三维CT、四维CT及锥形束CT确定食管癌原发肿瘤大体肿瘤体积的比较[J].中华放射医学与防护杂志,2017,37(6):430-436 |
| 基于增强三维CT、四维CT及锥形束CT确定食管癌原发肿瘤大体肿瘤体积的比较 |
| A comparison of gross tumor volume among three-dimensional, four-dimensional and cone beam computed tomography in primary esophageal cancer |
| 投稿时间：2016-12-12 |
| DOI：10.3760/cma.j.issn.0254-5098.2017.06.006 |
| 中文关键词: 食管肿瘤 三维CT 四维CT 锥形束CT 大体肿瘤体积 |
| 英文关键词:Esophageal cancer Three-dimensional computed tomography Four-dimensional computed tomography Cone beam computed tomography Gross tumor volume |
| 基金项目:国家重点研发计划项目（2016YFC0904700）；山东省重点研发计划项目（2016GSF201093） |
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| 中文摘要: |
| 目的 比较基于三维CT （3D-CT）、四维CT （4D-CT）和锥形束CT （CBCT）图像勾画的食管癌大体肿瘤靶区位置和体积差异。方法 34例食管癌患者序贯完成3D-CT、4D-CT扫描，放疗首次拍摄CBCT。分别在3D-CT、4D-CT呼气末时相、4D-CT最大密度投影（MIP）和CBCT图像勾画得到GTV3D、GTV4D50、IGTVMIP和IGTVCBCT，4D-CT 10个呼吸时相的GTV融合得到IGTV10，比较靶区间位置、体积和相互包含关系的差异。结果 胸上、中、下段大体肿瘤体积大小均为IGTV10>IGTVCBCT或IGTVMIP>GTV3D或GTV4D50。以IGTV10作为标准靶区，IGTV10与IGTVCBCT的漏误照均大于IGTV10与IGTVMIP的漏误照（t=-8.294~-3.192，P<0.05）。但IGTV10未被GTV3D包含比例与IGTV10未被IGTVCBCT包含比例间差异无统计学意义（P>0.05）。胸上段GTV4D50/IGTVCBCT与三维矢量成负相关（r=-0.756，P<0.05），IGTVCBCT与其余4个靶区中心在前后方向差异有统计学意义（t=-3.559~-2.435，P<0.05）。胸中段IGTV10/IGTVCBCT与三维矢量成正相关（r=0.695，P<0.05），IGTVCBCT和IGTV10靶区中心在前后方向差异有统计学意义（t=2.201，P<0.05），IGTV10未被IGTVCBCT包含比例与三维矢量成正相关（r=0.540，P<0.05）。胸下段IGTVCBCT和IGTVMIP靶区中心在左右方向差异有统计学意义（t=-2.365，P<0.05），IGTV10未被IGTVCBCT包含比例与三维矢量成正相关（r=0.678，P<0.05）。IGTVCBCT相对其余4个靶区的MI值为0.65~0.72。结论 CBCT图像包含的肿瘤运动信息量明显大于3D-CT图像，但小于4D-CT 10个时相融合包含的运动信息。CBCT与MIP图像包含相似的运动信息，但两者的靶区运动信息不能相互代替。 |
| 英文摘要: |
| Objective To analyze the volume and position of the gross tumor volumes (GTV) in primary esophageal cancer based on contrast-enhanced three-dimensional (3D),four-dimensional (4D) and cone beam (CB) computed tomography (CT). Methods A total of thirty-four patients underwent 3D-CT and 4D-CT simulation scans for computer treatment plan and contrast-enhanced CBCT scans were conducted prior to the first treatment.GTV3D,GTV4D50,internal GTVMIP(IGTVMIP) and internal GTVCBCT(IGTVCBCT) were delineated on 3D-CT,4D-CT50(the end expiratory phase),4D-CTMIP(the maximum intensity projection),and CBCT datasets,respectively.The IGTV10 was defined as 10 respiratory phases GTVs in 4D-CT.To evaluate the difference in position,volume and the volumes encompassed characteristic. Results The significant difference was observed in the volumes[IGTV10>(IGTVCBCT or IGTVMIP)>(GTV3D or GTV4D50)]regardless of the tumor location.Regarding IGTV10 as the standard volume,the underestimations or overestimations between IGTV10 and IGTVCBCT were larger than that of between IGTV10 and JGTVMIP(t=-8.294——3.192,P<0.05).However,there was no significant difference between the areas of IGTV10 which excluded in IGTVCBCT and IGTV3D(P>0.05).The GTV4D50/IGTVCBCT ratio for upper esophageal tumors was negatively correlated to motion vector (r=-0.756,P<0.05).The centroid coordinates of IGTVCBCT in AP direction were significantly different from the test volumes (GTV3D,GTV4D50,IGTVMIP and IGTV10)(t=-3.559——2.435,P<0.05).The IGTV10/IGTVCBCT ratio was positively correlated to motion vector (r=0.695,P<0.05) for middle esophageal tumors.The centroid coordinates of IGTVCBCT were significantly different IGTV10(t=2.201,P<0.05) in AP direction.For distal esophageal tumors,the significant difference was observed in the centroid coordinate between IGTVCBCT and IGTVMIP(t=-2.365,P<0.05) in LR direction.The percentage of IGTV10 excluded the IGTVCBCT were significantly correlated to the motion vector (r=0.540,0.678,P<0.05) for both middle and distal esophageal tumors.The mean MI value of IGTVCBCT to the other four test volumes ranged from 0.65 to 0.72. Conclusions CBCT has much motion information than 3D-CT but less than IGTV10.CBCT was similar to MIP images based on respiration motion.However,the target motion information encompassed in CBCT and MIP images cannot be exchanged to each other. |
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