| 付秀根,袁响林,郑祖安,等.光学表面监测系统在胸部肿瘤调强放疗的初步应用[J].中华放射医学与防护杂志,2019,39(2):101-106.Fu Xiugen,Yuan Xianglin,Zheng Zu'an,et al.Preliminary application of optical surface monitoring system in intensity-modulated radiotherapy for thoracic tumors[J].Chin J Radiol Med Prot,2019,39(2):101-106 |
| 光学表面监测系统在胸部肿瘤调强放疗的初步应用 |
| Preliminary application of optical surface monitoring system in intensity-modulated radiotherapy for thoracic tumors |
| 投稿时间：2018-06-22 |
| DOI：10.3760/cma.j.issn.0254-5098.2019.02.004 |
| 中文关键词: 胸部肿瘤 图像引导放疗 光学表面影像 摆位误差 锥形束CT |
| 英文关键词:Thoracic tumors Image-guided radiotherapy(IGRT) Optical surface imaging Setup errors Cone beam computed tomography |
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| 中文摘要: |
| 目的 探讨光学表面监测系统在胸部肿瘤调强放疗的摆位精度及其应用价值。方法 选取28例胸部肿瘤患者，应用体表标记与激光灯进行治疗前摆位，治疗前行锥形束CT（CBCT）扫描，扫描时通过光学表面监测系统获取表面影像，并与参考影像配准，记录x（左右）、y（头脚）与z（前后）轴的平移误差与旋转误差；扫描后CBCT图像与计划CT图像配准并记录x、y与z轴的平移误差与旋转误差，校正误差后治疗。应用Pearson法分析两组摆位误差的相关性，计算两组摆位误差的系统误差（Σ）与随机误差（σ）；应用Bland-Altman法评估两种影像系统的一致性，并计算95%的可信区间。结果 两组摆位误差有较好的相关性，相关系数在x、y、z轴分别为0.79、0.62、0.53，光学表面监测系统（OSMS）的Σ/σ（mm/mm）在x、y与z轴分别为0.7/1.5、0.9/1.8、0.9/1.5；CBCT的Σ/σ（mm/mm）在x、y与z轴分别为0.8/1.6、1.3/1.9、0.7/1.5；95%的可信区间在x、y与z轴的平移方向分别为（-2.0~2.3）、（-3.4~3.6）与（-3.3~2.4）mm，旋转方向分别为（-2.0~1.6）°、（-2.0~1.4）°与（-1.6~1.6）°。结论 OSMS是一种有效的图像引导工具，能快速准确地验证患者位置，提高摆位精度，可用于胸部肿瘤患者调强放疗的治疗摆位。 |
| 英文摘要: |
| Objective To investigate the accuracy and application value of optical surface monitoring system in intensity modulated radiotherapy for thoracic tumors patients. Methods Twenty-eight patients with thoracic tumors were included. During each treatment fraction, the patients were immobilized with body surface markers and laser lamps. The surface images obtained by the optical surface monitoring system were registered with the reference images and recorded during the CBCT scan. The translation and rotation errors of x(left-right), y(craniocaudal) and z (anterior-posterior) axes were recorded. After scanning, the CBCT images were registered with the planned CT images and the translation and rotation errors of x, y and z axes were recorded. The setup errors of these two image systems were analyzed and corrected before each treatment. The correlation between the two sets of setup errors were analyzed with Pearson test, and systematic error (Σ) and random error (σ) were also calculated. The consistency of the two image systems was evaluated with the Bland-Altman method and the 95% limits of agreement were calculated. Results There was a good correlation between these two groups, and the correlation coefficients were 0.79, 0.62, and 0.53 in x, y and z axes, respectively. The Σ/σ of the optical surface monitoring system were 0.7 mm/1.5 mm, 0.9 mm/1.8 mm and 0.9 mm/1.5 mm in x, y and z axes, respectively. The Σ/σ of CBCT were 0.8 mm/1.6 mm, 1.3 mm/1.9 mm and 0.7 mm/1.5 mm in x, y and z axes, respectively. The 95% limits of agreement of translations direction were (-2.0-2.3), (-3.4-3.6) and (-3.3-2.4) mm, and the 95% limits of agreement of rotation direction were (-2.0 to 1.6)°, (-2.0 to 1.4)° and (-1.6 to 1.6)° in x, y and z axes, respectively. Conclusions The optical surface monitoring system is an effective image guide tool, which can quickly and accurately verify the patient's position and improve the position accuracy. It can be applied for positioning in the intensity modulated radiation treatments for the thoracic tumor patients. |
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