中国癌症防治杂志
中國癌癥防治雜誌
중국암증방치잡지
CHINESE JOURNAL OF ONCOLOGY PREVENTION AND TREATMENT
2009年
2期
130-133
,共4页
陈炬辉%吴海山%郑步宏%李奇欣%柏朋刚%吴君心
陳炬輝%吳海山%鄭步宏%李奇訢%柏朋剛%吳君心
진거휘%오해산%정보굉%리기흔%백붕강%오군심
腮腺%MR%CT%调强放疗%鼻咽癌
腮腺%MR%CT%調彊放療%鼻嚥癌
시선%MR%CT%조강방료%비인암
Parotid%MRI%CT%IMRT%Nasopharyngeal carcinoma
目的 对鼻咽癌调强放疗的患者,在调强放疗的计划设计中,分别以MR及CT作为标准,勾画腮腺,比较其所勾画的腮腺体积差别及其对三维调强适形放疗(IMRT)计划中腮腺DVH的影响.方法 2008年5月至2008年11月间,20例实施根治性调强放疗的鼻咽癌患者,在放射治疗前1周行MR及增强定位CT扫描,并输入OTP治疗计划系统.然后将20例患者的CT影像及MR影像随机分成4组,由4名放疗科医师分别勾画其腮腺范围.之后将同一患者的CT及MR图像进行融合,评价所勾画的腮腺的体积差异,以CT为标准进行调强放疗计划设计,然后对比两种影像所勾画的腮腺的DVH的差别.结果 以CT和MRI为参照标准勾画的腮腺平均体积分别为(24.53±1.96×7.23)、(31.75± 1.96×12.05)cm3 ;V30 分别为(39.29± 1.96×9.30)%、(47.73±1.96×9.54)%;D50分别为(2 716±1.96×220)、(3 000 ±1.96×339)cGy.结论 以MR为标准勾画腮腺范围及体积较为准确,其与CT之差异主要集中在腮腺深叶及腮腺管、副腮腺区.以CT为标准勾画腮腺可能"遗漏"部分腮腺范围,并可能影响IMRT计划中部分腮腺的V30及D50评价的准确性.
目的 對鼻嚥癌調彊放療的患者,在調彊放療的計劃設計中,分彆以MR及CT作為標準,勾畫腮腺,比較其所勾畫的腮腺體積差彆及其對三維調彊適形放療(IMRT)計劃中腮腺DVH的影響.方法 2008年5月至2008年11月間,20例實施根治性調彊放療的鼻嚥癌患者,在放射治療前1週行MR及增彊定位CT掃描,併輸入OTP治療計劃繫統.然後將20例患者的CT影像及MR影像隨機分成4組,由4名放療科醫師分彆勾畫其腮腺範圍.之後將同一患者的CT及MR圖像進行融閤,評價所勾畫的腮腺的體積差異,以CT為標準進行調彊放療計劃設計,然後對比兩種影像所勾畫的腮腺的DVH的差彆.結果 以CT和MRI為參照標準勾畫的腮腺平均體積分彆為(24.53±1.96×7.23)、(31.75± 1.96×12.05)cm3 ;V30 分彆為(39.29± 1.96×9.30)%、(47.73±1.96×9.54)%;D50分彆為(2 716±1.96×220)、(3 000 ±1.96×339)cGy.結論 以MR為標準勾畫腮腺範圍及體積較為準確,其與CT之差異主要集中在腮腺深葉及腮腺管、副腮腺區.以CT為標準勾畫腮腺可能"遺漏"部分腮腺範圍,併可能影響IMRT計劃中部分腮腺的V30及D50評價的準確性.
목적 대비인암조강방료적환자,재조강방료적계화설계중,분별이MR급CT작위표준,구화시선,비교기소구화적시선체적차별급기대삼유조강괄형방료(IMRT)계화중시선DVH적영향.방법 2008년5월지2008년11월간,20례실시근치성조강방료적비인암환자,재방사치료전1주행MR급증강정위CT소묘,병수입OTP치료계화계통.연후장20례환자적CT영상급MR영상수궤분성4조,유4명방료과의사분별구화기시선범위.지후장동일환자적CT급MR도상진행융합,평개소구화적시선적체적차이,이CT위표준진행조강방료계화설계,연후대비량충영상소구화적시선적DVH적차별.결과 이CT화MRI위삼조표준구화적시선평균체적분별위(24.53±1.96×7.23)、(31.75± 1.96×12.05)cm3 ;V30 분별위(39.29± 1.96×9.30)%、(47.73±1.96×9.54)%;D50분별위(2 716±1.96×220)、(3 000 ±1.96×339)cGy.결론 이MR위표준구화시선범위급체적교위준학,기여CT지차이주요집중재시선심협급시선관、부시선구.이CT위표준구화시선가능"유루"부분시선범위,병가능영향IMRT계화중부분시선적V30급D50평개적준학성.
Objective To compare the differences of volume and DVH between the CT-defined and the MRI-defined parotids for intensity modulation radiated therapy (IMRT) planning on 20 patients with nasopharyngeal carcinoma (NPC).Methods Twenty patients diagnosed NPC from May 2008 to November 2008 were enrolled in this study.They received MRI and CT scan one week before radiotherapy and the images were transmitted to the treatment planning system,where the volume of parotid based on CT or MRI were contoured respectively.After fusing the CT/MRI image by using mutual information method,the difference of the volume between CT-defined and the MRI-defined parotid was evaluated.The IMRT plan was based on CT image,then the difference of DVH between CT-defined and MRI-defined parotid was compared.Results The mean volumes of parotid contoured on CT and on MRI were (24.53±1.96×7.23)cm3 and (31.75±1.96×12.05)cm3 respectively,the mean V30-CT and V30-MR were (39.29%±1.96×9.30)% and (47.73%±1.96×9.54)% respectively,and the mean D50-CT and D50MR were (2 716±1.96×220)cGy and (3 000±1.96×339)cGy respectively.Conclusion s The contoured volume based on MRI is more accurate than that based on CT.The main difference between them is at the deep leaf of the parotid,parotid duct and subparotid.Contouring the parotid based on CT image would miss some part of the parotid and would influence the accuracy of the V30 and D50 in some cases.
