脑转移肿瘤治疗与评价.ppt

图像要求：增强、序列、厚度、固定装置 MRI: Three-dimensional spoiled gradient (3D-SPGR) axial MRI scan of the head with standard axial and coronal FLAIR, axial T2-weighted and gadolinium contrast-enhanced T1-weighted sequence acquisitions . 1.25mm slice thickness is preferred to contour the hippocampus accurately. Slice thickness of 1.5mm or less is permitted. Obtain in supine position; immobilization devices used for CT simulation and daily radiation treatments not necessary. CT Simulation: Non-contrast treatment-planning CT scan of the entire head region. 1.25-1.5mm slice thickness is preferred for accurate hippocampal sparing planning. Slice thickness of 2.5mm or less is permitted. Immobilize patient in supine position using an immobilization device such as an Aquaplast mask over the head. Treat patients in the immobilization device. MRI-CT Fusion: Fuse the 3D-SPGR MRI and the treatment-planning CT. RTOG-0933 Red: Hippocampus Begin contouring at the most caudal (inferior) extent of the crescentic-shaped floor of the temporal horn of the lateral ventricle and contour the hypointense grey matter located medial to the CSF hypointensity, not the white, bright white matter. Temporal Horn MR Images courtesy of: Holmes CJ, Hoge R, Collins L, et al. Enhancement of MR Images Using Registration for Signal Averaging Journal of Computer Assisted Tomography 22,?324-333 (1998) Red: Hippocampus Fimbriae Continue contouring in a cephalad (superior) direction, medial to the temporal horn of the lateral ventricle and contour the hypointense grey matter, not the white, bright white matter. Red: Hippocampus Continue contouring in a cephalad (superior) direction. Avoid contouring the fimbriae, the T1-hyperintense structures located superomedial to the hippocampus. Fimbria Red: Hippocampus Continue contouring in a cephalad (superior) direction, medial to the temporal horn of the lateral ventricle and contour the hypointense grey matter, not the white, bright white matter. Note that the contours a