CAJ | 학술논문

目的初步测试自研发变形配准软件在四维CT (4DCT)图像上快速确定临床靶体积(CTV)和呼吸运动内靶体积(ITV)精度,评估其临床应用可行性.方法选择临床治疗的1例肺癌和1例肝癌的4DCT图像进行实验.用变形配准软件以单一呼吸时相CT图像勾画的CTV为参考自动生成其余呼吸时相的CTVdefm,并与放疗医师在每个呼吸时相CT图像勾画的CTVmanu比较,分析CTVdefm精度与适用范围.用CTVdefm叠加形成复合ITV comp,并与最大密度投影(MIP) CT图像勾画的ITVMIP比较轮廓、体积和几何中心位置差异.结果肺癌病例10个呼吸时相4DCT图像序列的CTVdefm与CTVmanu体积偏差平均值为(-2.59 ±5.02)％.与CTVmanu相比,CTVdefm的几何中心三维矢量偏差为(1.04±0.89) mm.肝癌患者ITVcomp与ITVMIP几何形状和位置几乎重合,体积差别＜1％,几何中心三维矢量差别为1.4 mm.结论测试变形配准软件系统在4DCT图像上自动生成CTV和呼吸运动ITV精度可满足临床计划设计要求.
목적 초보측시자연발변형배준연건재사유CT (4DCT)도상상쾌속학정림상파체적(CTV)화호흡운동내파체적(ITV)정도,평고기림상응용가행성.방법 선택림상치료적1례폐암화1례간암적4DCT도상진행실험.용변형배준연건이단일호흡시상CT도상구화적CTV위삼고자동생성기여호흡시상적CTVdefm,병여방료의사재매개호흡시상CT도상구화적CTVmanu비교,분석CTVdefm정도여괄용범위.용CTVdefm첩가형성복합ITV comp,병여최대밀도투영(MIP) CT도상구화적ITVMIP비교륜곽、체적화궤하중심위치차이.결과 폐암병례10개호흡시상4DCT도상서렬적CTVdefm여CTVmanu체적편차평균치위(-2.59 ±5.02)％.여CTVmanu상비,CTVdefm적궤하중심삼유시량편차위(1.04±0.89) mm.간암환자ITVcomp여ITVMIP궤하형상화위치궤호중합,체적차별＜1％,궤하중심삼유시량차별위1.4 mm.결론 측시변형배준연건계통재4DCT도상상자동생성CTV화호흡운동ITV정도가만족림상계화설계요구.
Objective To study preliminary the accuracy of clinical target volume (CTV) and internal target volume (ITV) automatically generated by an in-house deformable registration software on fourdimensional CT (4DCT),and evaluate its feasibility of clinical application.Methods Clinic treated one lung cancer patient and one liver cancer patient were selected for the study.CTV was delineated by radiation oncologist according to a single respiratory phase image of 4DCT scanning,and then deformed to the other phases and generated the CTVdefm on each phase image.Differences between the CTVdefm and CTVmanu were then compared.A composite ITVcopm was created by overlapping all the CTVdefm of 10 phases and compared with the ITVMIP which was contoured on the maximum intensity projection (MIP) CT images,including the shape,volume and geometric center position of the ITV contour.Results For the tested lung case,average volume difference between the CTVdefm and CTV was (-2.59 ± 5.02)％ for the all 10 phases,and the vector departure of the two ITV centers was (1.04 ± 0.89) mm.The ITVcomp almost completely matched the ITVMIP on the tested liver case with a volume difference smaller the 1％ and only 1.4 mm vector departure between their geometric centers.Conclusion The validity of the CTVdefm and ITVcomp gained from automatic deformation of manual delineation reference based on 4DCT images were preliminary evaluated and proved to be good enough for clinic planning.