北京生物醫(yī)學(xué)工程

膀胱癌放療中兩種圖像引導(dǎo)方法校準(zhǔn)精度比較

Comparing the calibration accuracy of two image guided methods in bladder cancer radiotherapy

作者：閆潔誠田龍胡逸民

單位：河北北方學(xué)院附屬第一醫(yī)院放療科（河北張家口 075000）中國醫(yī)學(xué)科學(xué)院北京協(xié)和醫(yī)科大學(xué)腫瘤醫(yī)院腫瘤研究所放療科（北京 100021）

關(guān)鍵詞：膀胱癌；錐形束CT；內(nèi)植標(biāo)記物；校準(zhǔn)

分類號：R318； R812

出版年·卷·期（頁碼）：2021·40·3（303-308）

摘要：

目的比較在膀胱癌放療中,基于錐形束CT的正交拍照和掃描兩種圖像引導(dǎo)方法校準(zhǔn)精度，從中選擇最合適膀胱癌放療的圖像引導(dǎo)方法。方法依據(jù)納排標(biāo)準(zhǔn)，篩選符合條件的15例膀胱癌患者，每周周一、周四使用錐形束CT對其進(jìn)行放療前正交拍照和掃描，分別采用自研算法和X線容積成像系統(tǒng)自帶算法計算兩種方法中由3枚內(nèi)植標(biāo)記物構(gòu)成的空間三角形質(zhì)心坐標(biāo)，之后分別同計劃CT重建獲取的空間三角形質(zhì)心坐標(biāo)比較，計算左右、腹背和頭腳方向上校準(zhǔn)位移絕對值和平均值，最后采用配對樣本t檢驗比較校準(zhǔn)精度。結(jié)果正交拍照法中，所有患者空間三角形質(zhì)心在左右，腹背和頭腳方向上校準(zhǔn)位移分別為0.994±0.773 mm，1.788±1.121 mm和2.443±1.357 mm；掃描法為0.812±0.215 mm，1.299±0.680 mm和1.871±1.092 mm。三個方向上正交拍照法校準(zhǔn)位移均較大于掃描法，差異無統(tǒng)計學(xué)意義（P＞0.05）。結(jié)論錐形束CT正交拍照法校準(zhǔn)精度略低于掃描法，但是在臨床實踐中，正交拍照法成像劑量低，操作時間短，對患者額外影響小，故選擇作為最合適膀胱癌放療的圖像引導(dǎo)方法。

Objective To compare the calibration accuracy of two image guided methods-orthogonal photography and scan based on cone beam CT in bladder cancer radiotherapy, so as to select the best image guidance method for bladder cancer radiotherapy. Methods Fifteen eligible patients with bladder cancer were screened according to the inclusion-exclusion criteria for test. Cone beam CT was used to take orthogonal photography and scan for the patients before radiotherapy twice a week on Monday and Thursday.?A self-developed algorithm and the built-in algorithm in X-ray volumetric imaging system were used to calculate the center coordinates of spatial triangle built with three implanted markers in two methods respectively. After that, absolute value and average value of calibration displacement on left-right, anterior-posterior and superior-inferior direction were calculated by comparing with the center coordinates of spatial triangle obtained in planned CT reconstruction respectively. Finally, paired sample t test was used to compare the calibration accuracy. Results The calibration displacement of the center of spatial triangle on left-right, anterior-posterior and superior-inferior direction for all the patients was 0.994±0.773 mm, 1.788±1.121 mm and 2.443±1.357 mm respectively in orthogonal photography method and 0.812±0.215 mm, 1.299±0.680mm and 1.871±1.092 mm respectively in scanning method. The calibration displacement of orthogonal photography method was larger than that of scanning method on three directions, and the differences were not statistically significant (P＞0.05). Conclusions The calibration accuracy of cone beam CT orthogonal photography method is slightly lower than that of scanning method. However, in clinical practice, the imaging dose of orthogonal photography method is low, working time is short and the additional effect on patients is small. Therefore, orthogonal photography method can be selected as the best image guidance method for bladder cancer radiotherapy.

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