CAJ | 학술논문

目的探讨CT、MR及CT与MR图像融合技术对鼻咽癌靶区勾画的准确性、可行性.方法共搜集36例鼻咽癌患者资料入组.所有患者治疗前均先在体表不同部位用铅点标记后行CT模拟定位扫描,行MR扫描前同一个位置也同样标记.将图像传输至Tomcon工作站用软件进行图像融合,并用LandMark方法进行配准,经我科放疗医师及放射科医师对配准进行评价和靶区勾画.对CT、MR及CT-MR图像数据分别进行比较.将试验对象按是否有斜坡破坏分两组并分别比较.按病变程度分层分析分为早期(T_1+T_2期)和进展期(T_3+T_4期)并分别比较.结果 GTV_(CT)、GTV_(MR)GTV_(CT-MR)平均值分别为27.60、30.99、31.71 cm~3(F=7.48,P=0.001),其中GTV_(CT)与GTV_(MR)(q=2.54,P=0.016)、GTV_(CT)与GTV_(CT-MR)(q=3.10,P=0.004)不同,GTV_(MR)与GTV_(CT-MR)相似(q=1.31,P=0.199).有斜坡破坏的GTV_(CT)、GTV_(MR)、GTV_(CT-MR)平均值分别为35.65、42.70、44.22 cm~3(F=14.13,P=0.000),无斜坡破坏的分别为20.79、20.46、21.18 cm~3(F=0.18,P=0.832).早期组GTV_(CT)和GTV_(CT-MR)相似(t=-0.66,P=0.514),进展期组的不同(t=-2.17,P=0.036).结论 CT与MR图像融合有助于提高临床靶区勾画的精确性,特别对斜坡侵犯的诊断及勾画上具有优势,在局部晚期患者具有明显优势,为临床医师提供了更多的理论依据.
목적 탐토CT、MR급CT여MR도상융합기술대비인암파구구화적준학성、가행성.방법 공수집36례비인암환자자료입조.소유환자치료전균선재체표불동부위용연점표기후행CT모의정위소묘,행MR소묘전동일개위치야동양표기.장도상전수지Tomcon공작참용연건진행도상융합,병용LandMark방법 진행배준,경아과방료의사급방사과의사대배준진행평개화파구구화.대CT、MR급CT-MR도상수거분별진행비교.장시험대상안시부유사파파배분량조병분별비교.안병변정도분층분석분위조기(T_1+T_2기)화진전기(T_3+T_4기)병분별비교.결과 GTV_(CT)、GTV_(MR)GTV_(CT-MR)평균치분별위27.60、30.99、31.71 cm~3(F=7.48,P=0.001),기중GTV_(CT)여GTV_(MR)(q=2.54,P=0.016)、GTV_(CT)여GTV_(CT-MR)(q=3.10,P=0.004)불동,GTV_(MR)여GTV_(CT-MR)상사(q=1.31,P=0.199).유사파파배적GTV_(CT)、GTV_(MR)、GTV_(CT-MR)평균치분별위35.65、42.70、44.22 cm~3(F=14.13,P=0.000),무사파파배적분별위20.79、20.46、21.18 cm~3(F=0.18,P=0.832).조기조GTV_(CT)화GTV_(CT-MR)상사(t=-0.66,P=0.514),진전기조적불동(t=-2.17,P=0.036).결론 CT여MR도상융합유조우제고림상파구구화적정학성,특별대사파침범적진단급구화상구유우세,재국부만기환자구유명현우세,위림상의사제공료경다적이론의거.
Objective To compare the accuracy and feasibility among CT, MR, and CT-MR image fusion technology in the delineation of gross target volume (GTV) for nasopharyngeal carcinoma (NPC). Methods Thirty-six consecutive patients with newly diagnosed or recurrent NPC were enrolled. Each pa-tient underwent both CT and MR scanning in the same treatment position. Several lead marks were made at the exactly same locations of the body surface before CT and MR scanning. The two sets of images were then transferred to the Tomcon workstation for image fusion. CT-MR image registration was performed using Land-Mark methods. GTV of each patient was contoured on CT (GTV_(CT)), MR (GTV_(MR)) and CT-MR (GTV_(CT-MR)) images. Results The mean GTV_(CT), GTV_(MR) and GTV_(CT-MR) were 27.60 cm~3, 30.99 cm~3 and 31.71 cm~3, respectively (F = 7.48, P = 0.001). Significant difference was found between GTV_(CT) and GTV_(MR) (q =2.54,P=0.016), GTV_(CT) and GTV_(CT-MR) (q =3.10,P =0.004), but not GTV_(MR) and GTV_(CT-MR) (q = 1.31 ,P = 0. 199). Significant difference among GTV_(CT), GTV_(MR) and GTV_(CT-MR) was found in patients with skull base invasion (35.65, 42.70 and 44.22 cm~3 ; F = 14. 13, P = 0. 000), but not in those without skull base invasion (20.79 cm~3, 20.46 cm~3 and 21.18 cm~3 ; F = 0.18, P = 0.832). Significant difference between GTV_(CT) and GTV_(CT-MR) was found in patients with T_3 and T_4 tumor (t = -2.17,P =0. 036), but not in those with T_1 and T_2 (t = -0.66 ,P = 0.514). Conclusions CT-MR image fusion is helpful in GTV de-lineation for NPC, particularly for patients with skull base invasion.