CAJ | 학술논문

目的探讨CT-MRI图像融合对前列腺癌调强放疗靶区及正常组织剂量影响.方法对10例经病理证实的中高危局限期前列腺癌患者行CT模拟定位和MRI图像采集.用CT-MRI图像融合软件确定同层面CT和MRI图像,分别在其上勾画前列腺和精囊腺靶区、直肠、膀胱等并对靶区进行调强放疗计划设计,比较它们在直肠和膀胱的剂量体积直方图参数间差异.结果 CT、MRI图像上勾画的前列腺+精囊腺平均体积分别为84.03、53.53 cm3(t=2.47,P=0.024),基于CT和MRI图像进行调强放疗计划设计后直肠V50、V60、V70分别为37.03%和30.28%(t=2.71,P=0.014)、24.99%和19.13%(t=2.83,P=0.011)、14.55%和9.53%(t=3.19,P=0.005);膀胱最大剂量分别为82.45 Gy和81.10 Gy(t=2.41,P=0.027).结论 MRI图像上勾画的前列腺+精囊腺体积比CT图像上勾画的小,基于MRI图像勾画靶区制定调强放疗计划比基于CT图像的可明显减少受较高剂量照射的直肠体积.
목적 탐토CT-MRI도상융합대전렬선암조강방료파구급정상조직제량영향.방법 대10례경병리증실적중고위국한기전렬선암환자행CT모의정위화MRI도상채집.용CT-MRI도상융합연건학정동층면CT화MRI도상,분별재기상구화전렬선화정낭선파구、직장、방광등병대파구진행조강방료계화설계,비교타문재직장화방광적제량체적직방도삼수간차이.결과 CT、MRI도상상구화적전렬선+정낭선평균체적분별위84.03、53.53 cm3(t=2.47,P=0.024),기우CT화MRI도상진행조강방료계화설계후직장V50、V60、V70분별위37.03%화30.28%(t=2.71,P=0.014)、24.99%화19.13%(t=2.83,P=0.011)、14.55%화9.53%(t=3.19,P=0.005);방광최대제량분별위82.45 Gy화81.10 Gy(t=2.41,P=0.027).결론 MRI도상상구화적전렬선+정낭선체적비CT도상상구화적소,기우MRI도상구화파구제정조강방료계화비기우CT도상적가명현감소수교고제량조사적직장체적.
Objective To explore the influence of computed tomography (CT) and magnetic resonance imaging (MRI) fusing technique on target volume and dosimetrics of normal tissues in intensity modulated radiotherapy (IMRT) for prostate carcinoma.Methods Ten patients with pathologically diagnosed moderate-high risk localized prostate carcinoma were enrolled in this study.CT and MRI images were collected.Same image slices of the prostate, seminal vesicles, rectum and bladder were anatomically delineated using image fusing software.Clinical target volume (CTV) was defined as the prostate plus seminal vesicles.IMRT treatment planning was designed basing on CT and MRI images, respectively.Differences of CTV volume and dose volume histogram of rectum and bladder between the two image groups were analyzed.Results The mean volume of CTV on CT and MRI images was 84.03 cm3 and 53.53 cm3,respectively (t =2.47,P=0.024).The V50, V60 and V70 of rectum were 30.28%, 19.13%, 9.53% on MRI and 37.03%, 24.99% and 14.55% on CT images, respectively, with significent difference (t =2.71,P=0.014 for V50; t =2.83,P=0.011 for V60; t=3.19,P=0.005 for V70).The maximal dose of bladder was 81.10 Gy on MRI and 82.45 Gy on CT, respectively(t=2.41,P=0.027).Conclusions By using image fusing technique, the mean volume of the prostate plus seminal vesicles delineated on MRI image is smaller as compared to CT image.The volume of the rectum receiving high irradiation dose can be reduced when MRI was used to delineate CTV compared to CT image.