| 孟鸿宇,江林宫,陈迪,伏少华,居小萍,张晓青,张火俊.胰腺癌射波刀治疗前CT定位增强扫描时间优化研究[J].中华放射医学与防护杂志,2017,37(6):442-446 |
| 胰腺癌射波刀治疗前CT定位增强扫描时间优化研究 |
| The optimization of enhancement scanning delay with CT-based simulation before cyberknife treatment for pancreatic cancer |
| 投稿时间：2016-11-26 |
| DOI：10.3760/cma.j.issn.0254-5098.2017.06.008 |
| 中文关键词: 胰腺癌 射波刀 CT模拟定位 扫描时间优化 |
| 英文关键词:Pancreatic cancer Cyberknife CT-based simulation enhancement Scanning time optimization |
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| 中文摘要: |
| 目的 探讨胰腺癌在进行射波刀治疗前CT模拟定位增强扫描的最优延迟时间，并分析此时间点靶区勾画与各评分指标的相关性。方法 使用16排大孔径螺旋CT定位机对拟行射波刀治疗的120例胰腺癌患者采用随机数字表法分为3组进行增强扫描，分别是：25、45和65 s组，30、50和70 s组和35、55和75 s组。扫描完成后根据图像质量评分表由3名副高职称以上放疗科医生分别进行评分。采用随机截距发展模型、Sidak法及单因素方差分析法进行分析，从而得出胰腺癌射波刀治疗CT模拟定位增强扫描的最优延迟时间。同时采用Pearson法分析此时间点时靶区勾画与各评分指标的相关性。结果 肿瘤边界、腹膜后淋巴结及十二指肠显示情况及靶区勾画把握度大小在45与65 s、50与70 s、55与75 s的图像评分差异无统计学意义（P>0.05），但分别高于同组内的25、30和35 s时的评分（t=3.59~21.68、13.34~15.46、12.42~13.83，P<0.05），因此最佳扫描时间范围为50~65 s，且55 s时靶区勾画把握度的均值最高（3.91±0.50），与肿瘤边界、十二指肠、腹膜后淋巴结显示情况及参考影像学检查的必要性均有一定的相关性，其中与肿瘤边界呈正相关（r=0.914 4，P<0.05），与参考影像学检查的必要性呈负相关（r=-0.926 3，P<0.05）。结论 胰腺癌射波刀治疗前CT定位增强扫描建议延迟时间为50~65 s，评分值最优时间点为55 s，靶区勾画的把握度与肿瘤边界显示情况呈明显正相关，与参考影像学检查的必要性呈明显负相关。 |
| 英文摘要: |
| Objective To assess the optimal delay time of enhanced scanning with CT-based simulation before cyberknife treatment for pancreatic cancer and to analyze the correlations between the target delineation and the rating items. Methods One hundred and twenty pancreatic cancer patients underwent Philips 16 big core spiral CT before cyberknife treatment.Patients were assigned to three groups randomly with scan delays of 25,45 and 65 s;30,50 and 70 s;and 35,55 and 75 s respectively.After the scanning,the images were evaluated by three associate professors in the field of radiation oncology.To achieve the optimal delay time,the data were compared with a random intercept model of mathematical mean,the Sidak method and One-way ANOVA.Pearson method was used to analyze the correlations between the target delineation and the rating items. Results The tumor boundaries,retroperitoneal lymph nodes,duodenal images,accuracy of target volume delineations in 45 and 65 s,50 and 70 s,55 and 75 s items rating difference had no statistically significant differences (P>0.05),but significantly superior to those in 25,30,35 s groups respectively (t=3.59-21.68,13.34-15.46,12.42-13.83,P<0.05).Therefore,the proposed delay time interval was 50-65 s,and the average value of the target volume delineation was the highest in 55 s group (3.91±0.50).When the scan delay time was 55 s,the target delineation was positively correlated with the tumor boundary (r=0.914 4,P<0.05),and negatively related to the value of other imaging (r=-0.926 3,P<0.05). Conclusions The recommended delay time interval of pancreatic cancer before cyberknife treatment CT enhanced scanning was 50-65 s,and the optimal time point was 55 s.The target volume delineation was positively correlated with the boundary of the tumor,and significant negatively related to the value of other imaging. |
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