CAJ | 학술논문

目的比较千伏级X线正交透视成像与锥形束CT (CBCT)成像方法在确定头颈部肿瘤患者摆位误差的一致性,为临床选择成像方法提供参考.方法将16例头颈部肿瘤患者共计160套正交透视图像与数字重建透视图像配准,160套CBCT图像与定位CT图像配准,得出患者左右(x)、上下(y)、前后(z)方向平移摆位误差.使用Pearson相关分析法检验相关性,Bland-Altman绘图法检验两种方法的一致性.结果 x、y、z方向R2值分别为0.768、0.832、0.727,P值均＜0.01,且两种方法的测量结果呈正相关.x、y、z方向95％一致性限度分别为[1.33 mm,-1.21 mm]、[1.58 mm,-1.08mm]、[0.79 mm,-1.37 mm],均＜2 mm界值,表明两种测量方法具有一致性.结论在确定头颈部肿瘤患者摆位误差时,千伏级X线透视与锥形束CT是一致的;考虑到CBCT成像剂量比透视成像剂量高一个数量级,且可提供更多解剖信息,建议将两种方法结合应用.
목적 비교천복급X선정교투시성상여추형속CT (CBCT)성상방법재학정두경부종류환자파위오차적일치성,위림상선택성상방법제공삼고.방법 장16례두경부종류환자공계160투정교투시도상여수자중건투시도상배준,160투CBCT도상여정위CT도상배준,득출환자좌우(x)、상하(y)、전후(z)방향평이파위오차.사용Pearson상관분석법검험상관성,Bland-Altman회도법검험량충방법적일치성.결과 x、y、z방향R2치분별위0.768、0.832、0.727,P치균＜0.01,차량충방법적측량결과정정상관.x、y、z방향95％일치성한도분별위[1.33 mm,-1.21 mm]、[1.58 mm,-1.08mm]、[0.79 mm,-1.37 mm],균＜2 mm계치,표명량충측량방법구유일치성.결론 재학정두경부종류환자파위오차시,천복급X선투시여추형속CT시일치적;고필도CBCT성상제량비투시성상제량고일개수량급,차가제공경다해부신식,건의장량충방법결합응용.
Objective Both kilovolt (KV) cone-beam computed tomography (CBCT) and KV radiography can determine set-up errors for patients with head-and-neck cancer.This study is to compare their performance.Methods 16 patients with head and neck cancer were enrolled in this study.There were 160 sets of CBCT and corresponding orthogonal radiography images.Through registration of CBCT images with the planning CT images,and registration of radiography images with the digitally reconstructed radiographs,translational set-up errors were determined along left-right (x),super-inferior (y),and anterior-posterior (z) directions.Pearson correlation analysis was performed to evaluate the correlation of the set up errors determined by the two methods,and Bland-Altman plot analysis was used to assess the coincidence of these two methods.Results The Pearson coefficient of correlation along all three directions was less than 0.01,and R2 was 0.95,0.84,0.81 on x,y,z,respectively.That means high correlation for two methods.The Bland-Altman plot analysis showed that the 95％ agreement limits of agreement were within preset 2 mm tolerance (x[ 1.3 mm,- 1.2 mm],y[ 1.6 mm,- 1.1 mm],z[0.8 mm,-1.4 mm] ),which indicates an agreement exists for two methods.Conclusions For determination of set-up errors for patients with head and neck cancer,KV radiography is equivalent to CBCT.Considering CBCT delivers higher dose than KV radiography,but provides more soft tissue information.We suggest to use these two methods combinative in clinic.