摘要
目的验证四维CT(4DCT)信息能否代表呼吸运动的实际情况,患者放疗前后呼吸活动是否有明显变化而影响4DCT在放疗中的应用。方法67例胸部肿瘤患者在GE discovery 16-slice PET/CT上行4DCT扫描,在AW 4.2 4D Advantage Sim 6.0工作站设计放疗计划。模拟机透视下观察放疗前后的呼吸频率、左右膈肌运动幅度、因呼吸不平稳导致膈肌运动超出4DCT测定范围的次数(脱靶率),比较呼吸频率和左右膈肌运动幅度在4DCT重建和模拟机透视下的差异。结果67例中58例能够重建出呼吸运动,其中32例放疗前后进行模拟机透视。放疗前后透视下呼吸频率和左右膈肌运动幅度的差异无统计学意义(P>0.100);4DCT重建与透视观察的呼吸频率差异无统计学意义(P>0.100);放疗前后脱靶率的差异有统计学意义(P<0.05);4DCT重建与透视下左右膈肌运动幅度的差异有统计学意义(P<0.05)。结论胸部肿瘤患者放疗前后呼吸状态基本一致,稳定性好;4DCT重建图像与患者呼吸保持一致性,但可能会遗漏部分信息。
Objective To verify the fidelity of four dimensional CT（4DCT） in assessing respiratory movement, and evaluate the influence of respiratory change between pre- and post-radiotherapy on 4DCT application in radiotherapy. Methods Patients with thoracic cancer received 4DCT scan with GE discovery 16-slice PET/CT. Radiotherapy plan was designed on AW 4.2 4D Advantage Sim 6.0 workstation. Respiratory frequency, bilateral diaphragmatic amplitude and dis-target rate observed by 4DCT and X-ray fluoroscopy simulator were compared by paired-samples t-test. Results Totally 67 patients received 4DCT scan, including 54 males and 13 females. Reconstruction of respiratory movement was made in 87% （58/67） patients, among whom 32 patients received fluoroscopy before and after radiotherapy. No statistically significant difference was observed in respiratory frequency and bilateral diaphragmatic amplitude between pre- and postradiotherapy, or in the respiratory frequency between 4DCT reconstruction and fluoroscopy （ P 〉 0.1 ）. Statistically significant differences were observed in dis-target rate between pre- and post-radiotherapy, and in bilateral diaphragmatic amplitude between 4DCT reconstruction and fluoroscopy （ P 〈 0.05）. Conclusions Respiratory status is fairly stable between pre- and post- radiotherapy in patients with thoracic carcinoma. The reconstruction image by 4DCT is conformal with the respiratory movement, but some information may be left out.
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2007年第4期302-305,共4页
Chinese Journal of Radiation Oncology
关键词
放射疗法
CT模拟
四维CT
验证
Radiotherapy
CT simulation
Four dimensional CT
Verification
