| 黄荣,滕建建,曾晓红,陈默.SPECT定义活性骨髓优化宫颈癌术后调强放疗计划的剂量学研究[J].中华放射医学与防护杂志,2018,38(6):419-423 |
| SPECT定义活性骨髓优化宫颈癌术后调强放疗计划的剂量学研究 |
| Application of active bone marrow defined with single photon emission computed tomography to optimize the intensity modulated radiotherapy plan in cervical cancer after hysterectomy |
| 投稿时间：2018-03-05 |
| DOI：10.3760/cma.j.issn.0254-5098.2018.06.004 |
| 中文关键词: 宫颈癌 调强 放疗 单光子发射计算机断层扫描 |
| 英文关键词:Cervical neoplasm Radiotherapy Intensity-modulated Single photon emission computed tomography |
| 基金项目:国家重点研发计划项目（2017YFC0113200） |
|
| 摘要点击次数: 2680 |
| 全文下载次数: 1463 |
| 中文摘要: |
| 目的 探讨单光子发射计算机断层扫描（SPECT）骨髓显像结合宫颈癌骨髓保护调强放疗计划的剂量学特点。方法 20例宫颈癌术后患者放疗前行99Tcm硫胶体SPECT骨髓显像确定盆骨中活性骨髓，采用图像融合技术将SPECT与定位CT融合。根据SPECT和盆骨外轮廓定义的骨髓体积，分别制定SPECT-IMRT（SPECT-intensity modulated radiotherapy）和骨髓剂量保护的调强放疗（bone marrow sparing-intensity modulated radiotherapy，BMS-IMRT）计划，比较两种计划的靶区和危及器官（骨髓、小肠、直肠和膀胱）剂量分布。靶区处方剂量45 Gy/25次。结果 SPECT-IMRT计划和BMS-IMRT计划定义的骨髓体积分别为（238.15±36.82）和（1 100.61±109.92）cm3（t=33.273，P<0.05）；SPECT-IMRT计划的骨髓高剂量辐射区V30、V40和V45的平均体积较BMS-IMRT计划分别降低6.9%、5.7%和2.6%，差异有统计学意义（t=3.540、3.426、3.448，P<0.05）；而低剂量辐射区V10和V20的平均体积比较差异无统计学意义（P>0.05）；两种计划PTV的覆盖率和其他危及器官（膀胱、小肠和直肠）的受照剂量差异均无统计学意义（P>0.05）。结论 SPECT骨髓显像能较清晰地在CT断层图像上显示活性骨髓的范围。与BMS-IMRT比较，SPECT-IMRT能进一步降低高剂量辐射的剂量体积（V30、V40和V45）。 |
| 英文摘要: |
| Objective To explore the dosimetric characteristics of single photon emission computed tomography (SPECT) combined with bone marrow sparing intensity modulated radiotherapy in patients with cervical cancer. Methods Twenty patients with cervical cancer after hysterectomy were performed on 99Tc thiocolloid SPECT bone marrow imaging to determine the active bone marrow in the pelvis. SPECT image combined with the simulation CT was used as the primary planning data set. Two plans for bone marrow sparing modulated radiotherapy were generated according to the bone marrow volume defined by SPECT and outline of the pelvis (SPECT-IMRT planning and BMS-IMRT planning). Furthermore, the target section and the dosimetric distribution in organs at risk (bone marrow, small intestine, rectum and bladder) in the two plannings were compared. The prescribed dose to the PTV was 45 Gy. Results The volume of the bone marrow in SPECT-IMRT planning and BMS-IMRT planning was (238.15±36.82) and (1 100.61±109.92) cm3, respectively (t=33.273,P<0.05). The average bone marrow volume of SPECT-IMRT planning in high-dose radiation region (V30, V40 and V45) was decreased by 6.9%, 5.7% and 2.6% respectively compared with BMS-IMRT planning (t=3.540,3.4261,3.448, P<0.05), but there was no statistical significant difference between the two plannings in the dose volume of low-dose radiation (V10 and V20, P>0.05). The PTV coverage rate and exposure dose of other organs at risk (small intestine, rectum and bladder) in the two plannings were not significantly different (P>0.05). Conclusions SPECT bone marrow imaging could clearly show the range of active bone marrow on CT scan images. Compared with BMS-IMRT, SPECT-IMRT could further reduce the dose volume of high-dose radiation (V30, V40 and V45). Yet the clinical significance of this advantage also needs to be confirmed by large-scale clinical studies. |
| HTML 查看全文 查看/发表评论 下载PDF阅读器 |
| 关闭 |