CAJ | 학술논문

目的：探查呼吸运动对胸腹肿瘤影响头脚方向的形变规律及在没有4D-CT的条件下CT检测肿瘤振幅的边距(头脚方向)及如何修正放射治疗计划。方法将木球置于仿真装置托盘上对中心， CT扫描正常呼吸运动状态图像，层厚3 mm，扫描8次，比较肿瘤位置的改变，制定治疗计划，观察中心偏差值。结果肿瘤的实测振幅在理论最大振幅内，肿瘤中心由于呼吸运动影响存在一定偏差。结论肿瘤在呼吸运动的影响下，可在呼吸动度范围内任意位置移动。为此，在制定治疗计划时需考虑呼吸动度范围，以“理论最大振幅值”，即“肿瘤大小+呼吸动度值”为PTV。
목적：탐사호흡운동대흉복종류영향두각방향적형변규률급재몰유4D-CT적조건하CT검측종류진폭적변거(두각방향)급여하수정방사치료계화。방법장목구치우방진장치탁반상대중심， CT소묘정상호흡운동상태도상，층후3 mm，소묘8차，비교종류위치적개변，제정치료계화，관찰중심편차치。결과종류적실측진폭재이론최대진폭내，종류중심유우호흡운동영향존재일정편차。결론종류재호흡운동적영향하，가재호흡동도범위내임의위치이동。위차，재제정치료계화시수고필호흡동도범위，이“이론최대진폭치”，즉“종류대소+호흡동도치”위PTV。
Objective To explore the deformation law of the direction of head to feet of the thoracic and abdominal tumor within the respiratory movement, and to test the tumor amplitude margins (head to feet) through CT and correct the radiation treatment plan with no 4D-CT. Methods We placed a wooden ball on the tray of the mold and aligned it with the center. And a CT image of the normal breathing exercise state was scanned in a thickness of 3 mm for 8 times. The primary outcome was a comparison of the changes of the tumor location, a treatment plan and observation of the deviation of the tumor. Results The measure amplitude of the tumor in the theoretical maximum amplitude. A certain bias exists caused by the respiratory motion. Conclusions Under the influence of respiratory movement, the tumor can move anywhere within the scale of the respiratory motion. As a result, the limits of respiratory movement should be taken into account when a plan is developed. And the theory maximum of amplitude, i.e. PTV, equals the scale of tumor plus respiratory movement.