CAJ | 학술논문

目的筛选、评价适合应用于千伏特锥形束CT(KVCBCT)在线引导肺癌放疗的图像配准方法.方法选择16例行根治性放疗的非小细胞肺癌患者进入研究,每例患者每周行KVCBCT在线引导体位校正1次,共96幅KVCBCT图像用于研究.分别采用基于灰度的自动配准法、骨性结构的自动配准法、人工图像配准法和自动加手动图像配准法配准患者KVCBCT图像与计划没计CT图像.配准由1名医生完成,配准结果由另外1名医牛在对所用配准方法设盲的情况下进行评价与筛选,并对筛选出的最优图像配准方法的可重复性进行评价.结果基于灰度的自动配准法、骨性结构的自动配准法、人工图像配准法和自动加手动图像配准法的平均得分分别为2.7、2.4、3.0和3.7分,4个组评分差异有统计学意义(F=42.20,P<0.001).采用自动加手动图像配准法左右(LR)、头脚(SI)和前后(AP)方向上,同一医牛2次配准结果差值>3 mm所占比例分别为0、3%和6%,不同医生的分别为0、14%和0,医生与技术员的分别为8%、14%和8%.结论自动加手动图像配准法以其配准结果好、所需时间较短、临床应用可重复性强等特点适合应用于肺癌KVCBCT在线引导放疗.
목적 사선、평개괄합응용우천복특추형속CT(KVCBCT)재선인도폐암방료적도상배준방법.방법 선택16례행근치성방료적비소세포폐암환자진입연구,매례환자매주행KVCBCT재선인도체위교정1차,공96폭KVCBCT도상용우연구.분별채용기우회도적자동배준법、골성결구적자동배준법、인공도상배준법화자동가수동도상배준법배준환자KVCBCT도상여계화몰계CT도상.배준유1명의생완성,배준결과유령외1명의우재대소용배준방법설맹적정황하진행평개여사선,병대사선출적최우도상배준방법적가중복성진행평개.결과 기우회도적자동배준법、골성결구적자동배준법、인공도상배준법화자동가수동도상배준법적평균득분분별위2.7、2.4、3.0화3.7분,4개조평분차이유통계학의의(F=42.20,P<0.001).채용자동가수동도상배준법좌우(LR)、두각(SI)화전후(AP)방향상,동일의우2차배준결과차치>3 mm소점비례분별위0、3%화6%,불동의생적분별위0、14%화0,의생여기술원적분별위8%、14%화8%.결론 자동가수동도상배준법이기배준결과호、소수시간교단、림상응용가중복성강등특점괄합응용우폐암KVCBCT재선인도방료.
Objective To select the optimal registration method for on-line kilovoltage cone-beam CT (KVCBCT) guided lung cancer radiation and evaluate the reproducibility of the selected method. MethodsSixteen patients with non-small cell lung cancer were enrolled into this study.A total of 96 pre treatment KVCBCT images from the 16 patients were available for the analysis.Image registration methods were bone-based automatic registration,gray-based automatic registration,manual registration and semi-auto matic registration.All registrations were accomplished by one physician.Another physician blindly evaluated the results of each registration,then selected the optimal registration method and evaluated its reproducibili ty.Results The average score of the bone-based automatic registration,gray-based automatic registration, manual registration and semi-automatic registration methods was 2.4,2.7,3.0 and 3.7,respectively.The score of the four different groups had statistics significant difference (F = 42.20,P < 0.001).Using the semi-automatic registration method,the probability of the difference between two registration results more than 3 ram in the left-right,superior-inferior,and anterior-posterior directions was 0,3% and 6% by the same physician,0,14% and 0 by different physicians,and 8%,14% and 8% by physician and radiation therapist.Conclusions Semi-automatic registration method,possessing the highest score and accepted re producibility,is appropriate for KVCBCT guided lung cancer radiation.