CAJ | 학술논문

目的比较基于四维CT(4DCT)三种方法勾画非小细胞肺癌(NSCLC)内大体肿瘤靶体积(IGTV)位置和大小差异.方法 21例NSCLC患者行胸部4DCT模拟定位扫描,采用10个呼吸时相得到IGTV10、0%和50%时相得到IGTVEI+EE、在最大密度投影(MIP)图像上得到IGTVMIP.对比3种勾画方法所得IGTV10、IGTVEI+EE、IGTVMIP的位置、体积、包含度及匹配指数.结果 IGTV10、IGTVEI+EE、IGTVMIP的中心在x、y、z轴上平均差异＜1 mm且均相似(t=0.35～1.57、P=0.730～0.132).IGTV10＞IGTVET+EE(t=2.37、P=0.028),IGTV10与GTVMIP相似(t=1.95,P=0.065),IGTVEI+EE与IGTV10、IGTVMIP与IGTV10比值分别为0.85±0.08和0.92±0.11.IGTV10对IGTVEI+EE和IGTVMIP的包含度分别为84.78%±8.95%和88.47%±9.04%.IGTV10与IGTVEI+EE、IGTV10与IGTVMIP的匹配指数分别为0.85±0.09、0.86±0.09.结论基于4DCT不同方法所勾画的IGTV中心位置变化不明显;IGTVEI+EE和IGTVMIP均不能替代IGTV10,但IGTVMIP与IGTV10大小更接近;IGTVEI+EE与IGTV10比值与肿瘤运动矢量相关,肿瘤三维运动幅度大且体积较小时IGTVEI+EE与IGTV10比值较小.
목적 비교기우사유CT(4DCT)삼충방법구화비소세포폐암(NSCLC)내대체종류파체적(IGTV)위치화대소차이.방법 21례NSCLC환자행흉부4DCT모의정위소묘,채용10개호흡시상득도IGTV10、0%화50%시상득도IGTVEI+EE、재최대밀도투영(MIP)도상상득도IGTVMIP.대비3충구화방법소득IGTV10、IGTVEI+EE、IGTVMIP적위치、체적、포함도급필배지수.결과 IGTV10、IGTVEI+EE、IGTVMIP적중심재x、y、z축상평균차이＜1 mm차균상사(t=0.35～1.57、P=0.730～0.132).IGTV10＞IGTVET+EE(t=2.37、P=0.028),IGTV10여GTVMIP상사(t=1.95,P=0.065),IGTVEI+EE여IGTV10、IGTVMIP여IGTV10비치분별위0.85±0.08화0.92±0.11.IGTV10대IGTVEI+EE화IGTVMIP적포함도분별위84.78%±8.95%화88.47%±9.04%.IGTV10여IGTVEI+EE、IGTV10여IGTVMIP적필배지수분별위0.85±0.09、0.86±0.09.결론 기우4DCT불동방법소구화적IGTV중심위치변화불명현;IGTVEI+EE화IGTVMIP균불능체대IGTV10,단IGTVMIP여IGTV10대소경접근;IGTVEI+EE여IGTV10비치여종류운동시량상관,종류삼유운동폭도대차체적교소시IGTVEI+EE여IGTV10비치교소.
Objective To compare positional and volumetric differences of internal gross tumor volume (IGTV) delineated separately by three approaches based on four-dimensional CT (4DCT) for the primary tumor of non-small cell lung cancer (NLCLC). Methods Twenty-one patients with NLCLC underwent big bore 4DCT simulation scan of the thorax. IGTVs of the primary tumor of NSCLC were tumor on the MIP images were delineated to produce IGTVMIP. The position of the target center, the volume of target, the degree of inclusion (DI) and the matching index (MI) were compared reciprocally between IGTV10, IGTVEI+EE and IGTVMIP. Results Average differences between the position of the center of IGTVs on direction of x,y and z axes were less than 1 mm, with no statistically significant difference. The volume of IGTV10 was larger than that of IGTVEI+EE, the difference was statistically significant (t=2.37,P=0.028);the volume of IGTV10 was larger than that of IGTVMIP, but the difference was not statistically significant(t=1.95 ,P=0.065). The ratio of IGTVEI+EE with IGTV10, IGTVMIP with IGTV10 were 0.85±0.08 and 0.92±0.11, respectively. DI of IGTVEI+EE in IGTV10, IGTVMIP in IGTV10 were 84.78% ± 8. 95% and 88.47% ±9.04%. MI between IGTV10 and IGTVEI+EE, IGTV10 and IGTVMIP were 0.85 ±0.09, 0.86±0. 09, respectively. Conclusions The center displacement of the IGTVs delineated separately by the three different techniques based on 4DCT images are not obvious; IGTVEI+EE and IGTVMIP can not replace IGTV10 , however , IGTVMIP is more close to IGTV10 comparing to IGTVEI+EE . The ratio of GTVEI+EE with IGTV10 is correlated to the tumor motion vector. As the vector increases, the ratio of GTVEI+EE with IGTV10decreases, especially for small tumors.