摘要
背景与目的:脑胶质瘤术后靶区的准确勾画一直是调强适形放射治疗的难题,MRI和CT图像融合技术能够提高靶区勾画的准确性,但这种技术能否提高放疗医师勾画靶区的稳定性,目前尚不明确。本研究采用不同的MRI图像资源与定位CT图像融合,对胶质瘤术后行放射治疗的患者靶区勾画的准确性和稳定性进行研究。方法:将9例脑胶质瘤患者的术前和术后MRIT1WI增强相与CT定位图像采用标点法进行图像融合,在5次不同的时间分别在两种融合图像及CT定位图像上勾画临床靶区,评价标点法图像融合精度,并比较三组不同资源图像勾画CTV的体积大小及稳定性。结果:三维空间的融合精度均小于1.5mm,一致性指数在术前MRI与CT融合组(pre-matched组)、术后MRI融合组(post-matched组),CT组(conv组)分别为(68±9)%、(61±7)%、(41±12)%。3公共部分体积百分比分别为(82±7)%、(78±5)%、(65±8)%。结论:采用术前MRI与CT图像融合的方法在勾画放疗CTV的体积最大,稳定性最佳(P<0.05);而根据术前MRI在术后定位CT图像上勾画CTV的传统画法稳定性最差(P<0.05)。采用术后MRI与CT融合方法勾画CTV的体积与传统勾画方法相似,其稳定性与术前MRI同CT融合的方法相同。
Background and purpose： Accurate target delineation in IMRT setting has been a challenge for post-op- erative gliomas. The fusion technology with MR ＋ CT image registration could improve the accuracy of target delineation, but there are no reports as to whether this technique could increase the stability of target delineation. This study was to investigate the accuracy of different fusion technologies with MRI ＋ CT image registration so it could improve stability of target delineation of clinical target volume in patients with post-operative gliomas. Methods： The post-operative and pre-operative MRI ＋ CT were registrated in nine patients with post-operative gliomas. Clinical target volume in the two registration images and localized CT images were delineated at 5 different times. The image registration accuracy and stability of target delineation were also quantitatively assessed. Results： The registration accuracy in 3D space was always less than 1.5 mm. The concordance index in CT ＋ MRI（pre-matched） , CT ＋ MRI（post-matched） and CT（conv） were （68 ± 9） %, （61 ± 7） % and （41 ± 12）% respectively. The same volumes delineated with three sets of images were （82 ± 7）% for CT ＋ MRI（ prematched）, （78 ± 5） % for CT ＋ MRI（post-matched） and （65 ± 8） % CT（conv） , respectively. Conclusions： The volume delineated according to pre-operative MRI registered with CT image have the largest volume and the best stability（ P 〈 0.05）, The stability of target delineation by conventional methods have the worst stability（ P 〈 0.05）. The methods of post-opera- tive MRI registrated with CT have the same volume as the conventional modality and the same stability as the Post-MRI ＋ CT modality.
出处
《中国癌症杂志》
CAS
CSCD
2008年第1期46-50,共5页
China Oncology
