CAJ | 학술논문

目的探讨食管癌图像引导放疗(IGRT)时锥形束CT扫描后的6个自由度(6DF)的配准标志和配准方法 .方法选择IGRT前扫描的30组食管癌的锥形束CT图像和相应计划CT图像,并确定和勾画用于6DF图像配准的配准标志.以手动配准为基准,对比骨配准、灰度配准、手动配准和骨配准+手动配准的优劣.结果 IGRT治疗前运用勾画出的食管癌靶区旁骨性标志和椎管标志可进行快速而准确的6DF配准.骨配准+手动配准与手动配准在v旋转方向上不同-0.55°、-0.88°(t=2.55,P=0.020);骨配准与手动配准在x轴平移及v旋转方向上均不同,分别为0.12、-2.33mm及(t=5.75,P=0.000)-0.35°、-0.88°(t=3.00,P=0.007);灰度配准与手动配准在x轴平移及w旋转方向上均也不同,分别为7.20、-2.33mm(t=3.10,P=0.006)及-0.10°、-0.59°(t=2.81,P=0.011).骨配准+手动配准符合率最高(85.55%),骨配准和灰度配准相似(74.45%和74.45%).配准时间为手动配准(6.00～10.00 min)>骨配准+手动配准(1.00～5.00 min)>灰度配准(0.75～1.50 min)>骨配准(0.50～0.83 min).结论食管癌患者在IGRT治疗前的配准需要配准标志,结合配准时间和配准准确性,骨配准+手动配准方法最佳.
목적 탐토식관암도상인도방료(IGRT)시추형속CT소묘후적6개자유도(6DF)적배준표지화배준방법 .방법 선택IGRT전소묘적30조식관암적추형속CT도상화상응계화CT도상,병학정화구화용우6DF도상배준적배준표지.이수동배준위기준,대비골배준、회도배준、수동배준화골배준+수동배준적우렬.결과 IGRT치료전운용구화출적식관암파구방골성표지화추관표지가진행쾌속이준학적6DF배준.골배준+수동배준여수동배준재v선전방향상불동-0.55°、-0.88°(t=2.55,P=0.020);골배준여수동배준재x축평이급v선전방향상균불동,분별위0.12、-2.33mm급(t=5.75,P=0.000)-0.35°、-0.88°(t=3.00,P=0.007);회도배준여수동배준재x축평이급w선전방향상균야불동,분별위7.20、-2.33mm(t=3.10,P=0.006)급-0.10°、-0.59°(t=2.81,P=0.011).골배준+수동배준부합솔최고(85.55%),골배준화회도배준상사(74.45%화74.45%).배준시간위수동배준(6.00～10.00 min)>골배준+수동배준(1.00～5.00 min)>회도배준(0.75～1.50 min)>골배준(0.50～0.83 min).결론 식관암환자재IGRT치료전적배준수요배준표지,결합배준시간화배준준학성,골배준+수동배준방법 최가.
Objective To explore six-degree-of-freedom (6-DF) registration methods between planning and cone beam computed tomography (CBCT) during image-guided radiation therapy (IGRT) in esophageal cancer.Methods Thirty pairs of CBCT images acquired before radiation and the corresponding planning computed tomography (CT) images of esophageal cancer were selected for further investigation.Registration markers for 6-DF image registration were determined and contoured in those images.The results of registration as well as time cost were compared among different registration methods of bone match, gray value match, manual match, and bone plus manual match.Results Contouring bone and spinal canal posterior to the target volume of esophageal carcinoma as registration marker could make 6-DF registration quick and precise.Compared with manual match, set-up errors of v rotation in bone plus manual match (-0.55° vs.-0.88°, t=2.55, P=0.020), of x-axis and v rotation in bone match (0.12 mm vs.-2.33 mm, t=5.75, P=0.000; -0.35° vs.-0.88°, t=3.00, P=0.007), and of x-axis and w rotation in gray value match (7.20 mm vs.-2.33 mm, t=3.10, P=0.006; -0.10° vs.-0.59°, t=2.81, P =0.011) were significantly different.Compared with manual match, the coincidence rate of bone plus manual match was the highest (85.55%), followed by bone match and gray value match (74.45% and 74.45%).The time cost of each registration method from longest to shortest was:6.00 -10.00 minutes for manual match, 1.00 - 5.00 minutes for bone plus manual match, 0.75 - 1.50 minutes for gray value match, and 0.50 - 0.83 minutes for bone match.Conclusions Registration marker is useful for image registration of CBCT and planning CT in patients with esophageal cancer.Bone plus manual match may be the best registration method considering both registration time and accuracy.