[1]周琼,李永武,王奇,等. 基于形变配准和伪CT的鼻咽癌自适应放疗剂量评估[J].中国医学物理学杂志,2019,36(8):892-897.[doi:DOI:10.3969/j.issn.1005-202X.2019.08.006]
　ZHOU Qiong,LI Yongwu,WANG Qi,et al. Dosimetric evaluation of adaptive radiotherapy for nasopharyngeal carcinoma based on deformable registration and synthetic CT[J].Chinese Journal of Medical Physics,2019,36(8):892-897.[doi:DOI:10.3969/j.issn.1005-202X.2019.08.006]
点击复制

 基于形变配准和伪CT的鼻咽癌自适应放疗剂量评估()
分享到：

《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
36卷
期数:
2019年第8期
页码:
892-897
栏目:
医学放射物理
出版日期:
2019-08-26

文章信息/Info

Title:
 Dosimetric evaluation of adaptive radiotherapy for nasopharyngeal carcinoma based on deformable registration and synthetic CT
文章编号:
1005-202X（2019）08-0892-06
作者:
 周琼; 李永武; 王奇; 施国志; 庞晓燕; 周勤煊
 浙江大学医学院附属邵逸夫医院， 浙江 杭州 310016
Author(s):
 ZHOU Qiong;  LI Yongwu;  WANG Qi;  SHI Guozhi;  PANG Xiaoyan;  ZHOU Qinxuan
 Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
关键词:
 ; 鼻咽癌; 形变配准; 自适应放疗; kV CBCT; 伪CT; Velocity软件
Keywords:
 ; Keywords: nasopharyngeal carcinoma;  deformable registration;  adaptive radiotherapy;  kV cone beam computed tomography;  synthetic CT;  Velocity software
分类号:
R730.55；R312
DOI:
DOI:10.3969/j.issn.1005-202X.2019.08.006
文献标志码:
A
摘要:
 目的：基于形变配准千伏级锥形束CT（kV CBCT）生成的伪CT图像，探讨了鼻咽癌自适应放疗的优势和重要性。方法：选取10例鼻咽癌患者1套定位CT图像和每周的摆位验证kV CBCT图像，采用Velocity软件形变配准生成6套伪CT。定位图像CT0上制定的Arc计划Plan0分别复制到6套伪CT上：A组方案是不改变参数直接计算最终剂量；B组方案是重新优化设计计算剂量。A、B两组各6次计划的剂量分别形变配准累积到CT0上得到累积剂量Dose_actual和Dose_replan。比较A组、B组和原计划每周肿瘤靶区和危及器官体积以及累积剂量的变化。结果：10例患者PGTVnx、GTVnd、PTV、左右腮腺体积退缩比率为3.81%±7.67%、11.45%±9.89%、3.50%±2.50%、23.67%±7.39%、24.18%±6.69%。A组方案的靶区PGTVnx、GTVnd、PTV D95剂量比原计划平均每周分别下降了0.946、1.054、0.809、0.848、1.426、0.799 Gy，1.407、1.501、1.627、1.236、2.028、1.373 Gy，2.330、3.419、3.938、2.696、4.213、2.574 Gy。B组计划与原计划处方剂量吻合度较高。相比于原计划，A组左侧腮腺D50、Dmean分别提高0.43、0.10 Gy，V30降低了1.94%；右侧腮腺D50、Dmean、V30分别提高了2.59 Gy、2.81 Gy、8.97%。B组左侧腮腺D50、Dmean、V30比原计划分别降低1.22 Gy、1.13 Gy、4.15%，右侧腮腺D50、Dmean、V30比原计划提高了2.8 Gy、3.09 Gy、5.44%。结论：相对于实际照射剂量，应用形变配准kV CBCT生成伪CT图像的鼻咽癌自适应放疗，既保证肿瘤靶区剂量与原计划Plan0一致，同时降低了危及器官的累积照射剂量，具有一定程度的剂量学优势。
Abstract:
Abstract：Objective To evaluate the advantages and importance of adaptive radiotherapy for nasopharyngeal carcinoma based on the synthetic CT image generated by the deformable image registration of kV cone-beam CT (kV CBCT). Methods The weekly acquired kV CBCT images of 10 patients with nasopharyngeal carcinoma and a set of positioning CT image of one patient were selected in the study. A total of 6 sets of synthetic CT images were generated with the deformable image registration of Velocity software. The Arc plan (Plan0) designed based on the positioning image (CT0) was copied to 6 sets of synthetic CT images. In group A, the final dose was directly calculated without changing the parameters, while the dose in group B was re-calculated after the design was re-optimized. The doses of 6 plans in groups A and B were accumulated into CT0 to obtain the cumulative doses, namely Dose_actual and Dose_replan. The original plan (Plan0) was compared with plans in group A and group B, and the changes in the weekly volume and accumulative dose of tumor target areas and organs-at-risk were evaluated. Results The volume shrinkage rates of PGTVnx, GTVnd, PTV, left and right parotid glands in the 10 patients was 3.81%±7.67%, 11.45%±9.89%, 3.50%±2.50%, 23.67%±7.39%, 24.18%±6.69%, respectively. Compared with those in the original plan (Plan0), the weekly mean doses of the D95 of PGTVnx, GTVnd and PTV in 6 plans in group A were reduced by 0.946, 1.054, 0.809, 0.848, 1.426, 0.799 Gy, 1.407, 1.501, 1.627, 1.236, 2.028, 1.373 Gy, and 2.330, 3.419, 3.938, 2.696, 4.213, 2.574 Gy, respectively. The prescription dose of group B had a higher degree of agreement with that of original plan. Compared with the original plan (Plan0), group A had higher D50, Dmean of left parotid gland and D50, Dmean, V30 of right parotid gland which were increased by 0.43 Gy, 0.10 Gy, 2.59 Gy, 2.81 Gy, 8.97%, and a lower V30 of left parotid gland which were decreased by 1.94%. Compared with the original plan (Plan0), the D50, Dmean, V30 of left parotid gland in group B were decreased by 1.22 Gy, 1.13 Gy, 4.15%, while the D50, Dmean, V30 of right parotid gland were increased by 2.8 Gy, 3.09 Gy, 5.44%. Conclusion The adaptive radiotherapy for nasopharyngeal carcinoma which is designed based on synthetic CT generated by the deformable image registration of kV CBCT can guarantee that the target dose coverage is consistent with that of Plan0 and reduce the cumulative dose of organs-at-risk, with significant dosimetric advantages.

相似文献/References:

[1]陈广涛,汪 淇,刘亚强,等.TrueBeam加速器射野准直器跟随功能在鼻咽癌固定野调强放疗和容积旋转调强放疗中的应用[J].中国医学物理学杂志,2014,31(03):4865.[doi:10.3969/j.issn.1005-202X.2014.03.005]
[2]潘宇辉,陈榕钦,柏朋刚,等.鼻咽癌调强放射治疗前后腮腺体积及空间几何位置变化研究[J].中国医学物理学杂志,2014,31(05):5120.[doi:10.3969/j.issn.1005-202X.2014.05.005]
[3]张俊俊,邱小平,李奇欣,等.ArcCheck系统在鼻咽癌容积旋转调强剂量验证中的应用[J].中国医学物理学杂志,2014,31(05):5136.[doi:10.3969/j.issn.1005-202X.2014.05.009]
[4]桑 勇,陈维军,狄小云,等.多叶光栅叶片宽度对鼻咽癌剂量学的影响[J].中国医学物理学杂志,2014,31(06):5240.[doi:10.3969/j.issn.1005-202X.2014.06.004]
[5]黄利生,庄婷婷,伍方财,等.鼻咽癌调强放疗Ib区剂量分析[J].中国医学物理学杂志,2014,31(06):5265.[doi:10.3969/j.issn.1005-202X.2014.06.010]
[6]易金玲,金献测,周永强,等.鼻咽癌IMRT与VMAT治疗的计划与剂量验证比较研究[J].中国医学物理学杂志,2013,30(01):3859.[doi:10.3969/j.issn.1005-202X.2013.01.006]
[7]金献测,易金玲,周永强,等.鼻咽癌同步加量调强放射治疗新的计划质量评估指标研究[J].中国医学物理学杂志,2013,30(02):3978.[doi:10.3969/j.issn.1005-202X.2013.02.004]
[8]蒋晓芹,段宝风,艾平,等.基于图谱库的自动轮廓勾画软件(ABAS)在鼻咽癌调强放疗中的应用[J].中国医学物理学杂志,2013,30(02):3997.[doi:10.3969/j.issn.1005-202X.2013.02.008]
[9]张达光,蒋胜鹏,李智华,等.鼻咽癌调强放疗中解剖结构改变及剂量分布变化的研究[J].中国医学物理学杂志,2013,30(04):4239.[doi:10.3969/j.issn.1005-202X.2013.04.006]
[10]杨海燕,王军良,周振山,等.AAA算法和PBC算法在鼻咽癌调强放疗中剂量分布的比较[J].中国医学物理学杂志,2013,30(04):4245.[doi:10.3969/j.issn.1005-202X.2013.04.008]
[11]张晓辉,王淑侠,徐卫平,等. PET/CT增强在鼻咽癌头颈部淋巴结转移的应用价值[J].中国医学物理学杂志,2016,33(9):939.[doi:10.3969/j.issn.1005-202X.2016.09.014]
　[J].Chinese Journal of Medical Physics,2016,33(8):939.[doi:10.3969/j.issn.1005-202X.2016.09.014]
[12]蒋璐,邱小平,单国平,等. 鼻咽癌放疗中摆位误差及解剖结构变化对剂量学的影响[J].中国医学物理学杂志,2017,34(4):348.[doi:DOI:10.3969/j.issn.1005-202X.2017.04.006]
[13]胡邦,唐承佩,刘小芳,等. 基于等效均匀剂量的目标函数对鼻咽癌调强放疗中颞叶的保护[J].中国医学物理学杂志,2017,34(5):472.[doi:DOI:10.3969/j.issn.1005-202X.2017.05.008]
[14]王占宇,曾自力,谭军文. 基于电子射野影像系统的鼻咽癌调强放疗摆位误差纠正及其应用[J].中国医学物理学杂志,2017,34(9):887.[doi:DOI:10.3969/j.issn.1005-202X.2017.09.006]
　[J].Chinese Journal of Medical Physics,2017,34(8):887.[doi:DOI:10.3969/j.issn.1005-202X.2017.09.006]
[15]苏欢繁,全红,梁志文,等.鼻咽癌放疗中3种调强技术对摆位误差的敏感性[J].中国医学物理学杂志,2017,34(11):1102.[doi:DOI:10.3969/j.issn.1005-202X.2017.11.005]
　SU Huanfan,QUAN Hong,LIANG Zhiwen,et al. Sensitivity of 3 kinds of intensity-modulated radiotherapy techniques to setup errors in radiotherapy for nasopharyngeal carcinoma[J].Chinese Journal of Medical Physics,2017,34(8):1102.[doi:DOI:10.3969/j.issn.1005-202X.2017.11.005]
[16]刘礼东,杨振,邱小平,等. 利用Delta4对放疗计划进行剂量体积直方图评价的可行性研究[J].中国医学物理学杂志,2018,35(1):25.[doi:DOI:10.3969/j.issn.1005-202X.2018.01.006]
　LIU Lidong,YANG Zhen,QIU Xiaoping,et al. Feasibility of Delta4 for plan evaluation based on dose-volume histogram[J].Chinese Journal of Medical Physics,2018,35(8):25.[doi:DOI:10.3969/j.issn.1005-202X.2018.01.006]
[17]赵洪利,刘晖,钟亚华,等. TomoDirect技术在鼻咽癌放疗中的剂量学研究[J].中国医学物理学杂志,2018,35(2):166.[doi:DOI:10.3969/j.issn.1005-202X.2018.02.009]
　ZHAO Hongli,LIU Hui,ZHONG Yahua,et al. Dosimetric study of TomoDirect technology in radiotherapy for nasopharyngeal carcinoma[J].Chinese Journal of Medical Physics,2018,35(8):166.[doi:DOI:10.3969/j.issn.1005-202X.2018.02.009]
[18]刘国才,官文静,田娟秀,等. 集成自适应回归核的肿瘤生物靶区随机游走勾画方法[J].中国医学物理学杂志,2018,35(7):758.[doi:DOI:10.3969/j.issn.1005-202X.2018.07.004]
　LIU Guocai,GUAN Wenjing,TIAN Juanxiu,et al. A random walk method with adaptive regression-kernel for delineation of biological target volumes of tumors[J].Chinese Journal of Medical Physics,2018,35(8):758.[doi:DOI:10.3969/j.issn.1005-202X.2018.07.004]
[19]滕建建,石锦平,张利文,等. 鼻咽癌容积调强剂量验证与计划复杂性的相关性[J].中国医学物理学杂志,2018,35(7):781.[doi:DOI:10.3969/j.issn.1005-202X.2018.07.008]
　TENG Jianjian,SHI Jinping,ZHANG Liwen,et al. Correlation between dose verification and plan complexity of volumetric modulated arc therapy for nasopharyngeal carcinoma[J].Chinese Journal of Medical Physics,2018,35(8):781.[doi:DOI:10.3969/j.issn.1005-202X.2018.07.008]
[20]杨海松,聂晓历,刘利彬,等. 鼻咽癌螺旋断层调强放疗中优化MVCT扫描范围的可行性[J].中国医学物理学杂志,2018,35(8):874.[doi:DOI:10.3969/j.issn.1005-202X.2018.08.002]
　YANG Haisong,NIE Xiaoli,LIU Libin,et al. Feasibility on optimizing MVCT scan range in tomotherapy of nasopharyngeal carcinoma[J].Chinese Journal of Medical Physics,2018,35(8):874.[doi:DOI:10.3969/j.issn.1005-202X.2018.08.002]

备注/Memo

备注/Memo:
 【收稿日期】2019-01-16
【基金项目】浙江省医药卫生科研项目（2018243203）
【作者简介】周琼，硕士，助理工程师，研究方向：放射物理治疗，E-mail: 3415009@zju.edu.cn
更新日期/Last Update: 2019-08-26