Cone-BeamCT 与DRR 在鼻咽癌IGRT 图像配准中的差异.docVIP

精品论文 参考文献 Cone-BeamCT 与DRR 在鼻咽癌IGRT 图像配准中的差异 尹中明 周华娟 孙龙 颜金明 狄小云浙江省肿瘤医院物理室 浙江杭州 310000 　　【摘 要】 目的 比较用千伏级锥形束CT 与千伏级X 线DRR 方法在鼻咽癌调强放射治疗中测量到的摆位误差，为鼻咽癌影像引导放疗提供参考。 方法 选取正在实施IMRT 治疗的鼻咽癌患者23 例，在治疗实施前先为患者拍摄正侧位的kV-X 线透视图像，再进行kV-CBCT 扫描。 　　将X 线正侧位片与数字重建射野影像（DRR）手动配准，得出左右（x）、上下（y）、前后（z）三个方向上的摆位误差值，再将CBCT 图像与计划CT 图像进行自动的骨性配准，得出x、y、z 方向上的摆位误差值。使用Spearman 相关分析法检验相关性，Bland-Altman 绘图法检验两种方法的一致性。 结果 两种方法x、y、z 方向上的Spearman 相关系数为0.633，0.867，0.733，P 值均小于0.01，为显著相关；x、y、z 方向95％一致性限度分别为[0.26，-0.22]，[0.21，-0.23]，[0.21，-0.33]，均大于2mm 界值。表明两种方法虽然存在显著相关性，但缺乏足够的一致性。 结论 kVDRR 与CBCT 一致性超出了0.2cm 的界值，尚不足以替代CBCT。考虑到kVDRR 的剂量比CBCT 小一个数量级，临床中仍然可以根据实际情况，考虑将kVDRR 与CBCT 联合运用。 　　【关键词】千伏级锥形束；千伏级X 线；图像配准；摆位误差【中图分类号】R812【文献标识码】A【文章编号】1276-7808（2014）04-088-02【Abstract】 Objective：To compare the setup errors measured by kV-CBCT and kV radiography for the nasopharyngeal carcinoma patients，to evaluatethe application value of the two methods.Methods：23 nasopharyngeal carcinoma patients were enrolled in this study.Before the treatment，kV radiographyimages were taken，and were matched manually with the DRR images to get the set-up errors in x，y，z axis.Then，kV-CBCT images were taken，and werematched in bony value with the CT images to get the set-up errors in x，y，z axis.Spearman correlation analysis was performed to evaluate the correlation of thesetup errors obtained from the two methods.And the Bland-Altman plot analysis was performed to assess the coincidence of the two methods.Results：TheSpearman correlation coefficients of the two methods on x，y，z axis are 0.633，0.867，0.733，respectively，and all the P values are less than 0.01.The 95%agreement limits in Bland-Altman plot analysis along x，y，z axis are [0.26，-0.22]，[0.21，-0.23]，[0.21，-0.33]，which exceed the preset 2 mm tolerance.Itindicates that the setup errors of the two methods are correlated significantly，while there is lack of an agreement.Conclusion：kV radiography is not sufficient tobe an alternative method of CBCT in measuring setup errors for nasopharyngeal c