对多发转移病灶在螺旋断层治疗中影像引导方案的评估
Chinese Journal of Radiological Medicine and Protection（2014）
Abstract
目的 比较在靶区范围内进行一个解剖部位的图像引导与两个解剖部位图像引导两种方案对大范围多发转移病灶放疗精度的影响,为临床选择提供参考.方法 收集50例利用螺旋断层放疗机治疗的靶区长度超过50 cm的多发转移瘤患者的图像数据,将治疗分次内两个部位共计1 220次影像引导数据与定位CT图像进行配准,统计两个部位的摆位误差偏差分布,检验平移误差的一致性,并检验两个部位摆位误差的相关性.结果 两个部位的摆位误差偏差较大,在左右(x)、头脚(y)、前后(z)方向上的摆位误差大于3 mm的频度分别为34％、46％和28％;大于5 mm的频度分别为10％、16％和8％.x、y、z方向95％一致性限度分别为(9.3,-10.6)、(10.5,-11.7)、(7.3,-6.9)mm,均＞5 mm界值,表明两个部位的图像配置数据不一致.在x、y、z方向上的摆位误差的R2值分别为0.074、0.475、0.178(P ＜0.05),在y方向上具有中等程度相关(0.4 ～0.6)外,x、z方向为弱相关.结论 在对大范围多发转移患者进行摆位误差修正时,建议使用分次内双解剖部位图像引导方案.
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Key words
Multiple metastases,Tomotherapy,Image guidance,Setup errors
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