摘要
目的对比在实时针道计划下携带^(125)I粒子的可降解导管植入和徒手粒子植入后靶区各项剂量学参数的差异。方法本实验模拟病灶42个,分为徒手组21个和导管组21个。根据治疗计划系统进行粒子植入。分别记录术前、术后的最小剂量(D_(min))、最大剂量(D_(max))、平均剂量(D_(mean))、适形指数(CI)、靶外体积指数(EI)、均匀性指数(HI)、覆盖90%靶体积的剂量(D90)、90%处方剂量覆盖靶体积的百分比(V90)。通过Bland-Altman法分析术前、术后剂量参数的一致性,组间比较采用秩和检验。结果经Bland-Altman法分析,两组术前、术后大部分参数均具有较好的一致性,仅徒手组D_(min)和V_(90)的一致性欠佳。但是导管组在D_(max)(Z=-3.824,P<0.005)、CI(Z=-1.962,P<0.005)、HI(Z=-2.352,P<0.005)、D90(Z=-2.453,P<0.005)、V90(Z=-2.845,P<0.005)的参数误差范围更小。结论实时针道计划下携带^(125)I粒子的可降解导管植入术前、术后剂量学参数均具有较好的一致性,且剂量参数值误差范围更小。
Objective To compare the differences in dosimetric parameters of target areas between ^(125)I seed implantation with degradable catheters and by hand under the assistance of a real-time intraoperative treatment planning system(TPS).Methods Forty-two simulated lesions were divided into a degradable catheter group and a free-hand group,with twenty-one lesions in each group.^(125)I seeds were implanted according to the TPS.The pre-plan and post-implant dosimetric parameters were collected,including the minimum dose(Dmin),maximum dose(D_(max)),mean dose(D_(mean)),conformal index(CI),external index(EI),homogeneity index(HI),minimum prescription dose delivered to 90%of the target volume(D90),and the mean percentage of volume receiving 90%of the prescription doses(V90).The Bland-Altman method was employed to analyze the consistency of pre-plan and post-implant dosimetric parameters and the Wilcoxon rank-sum test was used for the comparison of the two groups.Results According to the Bland-Altman analysis,the dosimetric parameters of the two groups were all in agreement before and after seed implantation except for the Dmin and V90 of the free-hand group.Furthermore,the degradable catheter group had smaller error ranges of D_(max)(Z=-3.824,P<0.005),CI(Z=-1.962,P<0.005),HI(Z=-2.352,P<0.005),D90(Z=-2.453,P<0.005),and V90(Z=-3.159,P<0.005).Conclusions The dosimetric parameters of ^(125)I seed implantation with degradable catheters under the assistance of real-time TPS have good pre-plan and post-implant consistency and smaller error ranges.
作者
刘云
何闯
梁清华
陈玉潇
李良山
袁晶
李廷源
黄学全
Liu Yun;He Chuang;Liang Qinghua;Chen Yuxiao;Li Liangshan;Yuan jing;Li Tingyuan;Huang Xuequan(Department of Oncology,Daping Hospital,Army Medical University,Chongqing 400042,China;Center of Minimally Invasive,Southwest Hospital,Army Medical University,Chongqing 400038,China)
出处
《中华放射医学与防护杂志》
CAS
CSCD
北大核心
2021年第1期62-65,共4页
Chinese Journal of Radiological Medicine and Protection
基金
重庆市技术创新与应用发展(科技扶贫专项)(CSTC2019JSCX-KJFP0005)。
