4DCT肺通气图像在非小细胞肺癌NSCLC放疗计划设计中对功能肺保护.docx

优秀毕业论文 精品参考文献资料 Impact of incorporating four-dimensional computed tomography pulmonary ventilation images into treatment planning for non-small cell lung cancer (NSCLC) to preserve functional lung Abstract Objective 4D-CT ventilation images were created using deformable image registration for spatial mapping of the peak-exhale 4D-CT image to the peak-inhale image. To assess the impact of incorporating four-dimensional computed tomography pulmonary ventilation images into intensity-modulated radiation therapy planning for non-small cell lung cancer(NSCLC) to preserve functional lung. Methods Six patients with NSCLC underwent 4D-CT scanning, and got ten bins CT images. Paired 4D-CT images at the peak-exhale and peak-inhale phases were used for deformable image registration and quantitative analysis of the displacement vector field (DVF). The Jacobian determinant of deformation was used as ventilation metric. Ventilation images were created by processing DVF data through MATLAB (MathWorks, Natick, MA, USA) routine. The Ventilation images were superimposed on the CT image using registration software of treatment planning system. High-function lung which defined as the value of Jacobian greater than 1.2 were delineated using the Ventilation images. Two IMRT (IMRT and f-IMRT) plans were designed: an anatomic plan using CT alone and a functional plan using Ventilation images in addition to the CT. Traditional IMRT plans treated the lung as uniformly PAGE PAGE 5 functional. All lung, spinal cord, esophagus and heart had the same dose-volume constraints in IMRT and f-IMRT plans. Functional planning spared the high-functional lung in additional to the critical organs. Comparing the difference between IMRT and f-IMRT: (1) The discrepancy of high-functional lung dose and other critical organ doses between IMRT and f-IMRT; (2) The Conformity Index (CI) and Heterogeneity Index (HI) of PTV; (3) the dose distribution of ipsilateral high-functional lung and the contralateral high