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目的比较调强放射治疗中4种配对图像获得的放射治疗摆位误差。方法选择2012年南通市第一人民医院住院行放射治疗胸腹部肿瘤患者17例,其中男性12例,女性5例;年龄32~81岁,中位年龄66岁。获取17例胸腹部调强放射治疗患者3组二维(2D)(k V-k V、k V-MV、MV-MV)配对图像和1组三维锥形束CT(3D-CBCT)配对图像,通过根据灰度自动配准及由专业放射治疗医师根据靶区和解剖学结构手动配准,获取摆位误差和临床靶体积(CTV)到计划靶体积(PTV)的预留边界并分析差异。结果 3组2D配对图像摆位误差差异有统计学意义,差值在2 mm以内。3组2D与3D配对图像摆位误差差异无统计学意义。4组CTV到PTV的预留边界差距在2 mm以内。结论 4种图像引导方式均能达到临床需要,建议根据设备配置情况灵活选用。
Objective To compare the radiotherapy setup errors obtained from four kinds of matched images in intensity modulated radiation therapy. Methods 17 cases of thoracoabdominal tumor were treated by radiotherapy of thoracoabdominal tumor in the First People’s Hospital of Nantong City in 2012, including 12 males and 5 females; their ages ranged from 32 to 81 years with a median age of 66 years. Seven pairs of two-dimensional (2D) kVk V, MV-MV matching images and one 3D-CBCT matching image were obtained from 17 cases of thoracoabdominal intensity modulated radiation therapy. Automated registration of grayscale and manual registration by the professional radiotherapist based on the target area and the anatomy were used to obtain setup error and reserve boundaries between clinical target volume (CTV) and planned target volume (PTV) and to analyze differences. Results There were significant differences in the positioning error between the three groups of 2D paired images, the difference was within 2 mm. There was no significant difference in the setup error between the 3 groups of 2D and 3D paired images. The difference of the reserved boundary between CTV and PTV in 4 groups was less than 2 mm. Conclusion All the 4 kinds of image guidance methods can meet the clinical needs, and it is suggested that they should be flexibly selected according to the equipment configuration.