CT／MRI融合技术在鼻咽癌调强放疗靶区勾画中的应用研究

Clinical Research of Target Contour in NPC IMRT using CT/MRI Fusion Technique

目的探讨CT和MRI融合技术在鼻咽癌调强放疗靶区勾画中的应用价值。方法选取行调强放射治疗的鼻咽癌患者1例，由5名高年资放射治疗科医师在单一CT图像状态和CT／MRI融合状态下分别勾画鼻咽肿瘤靶区（分别以GTVCT和GTVfusion表示），比较单一CT图像状态和CT／MRI融合状态下不同医生间鼻咽肿瘤靶区勾画的差异性，研究影像融合技术对靶区勾画的影响。结果GTVfusion比GTVCT大，单一CT图像状态下的肿瘤靶区（GTV）在不同医生间存在较大的差异，而CT／MRI融合能显著缩小不同医师间靶区勾画的差异性，从而提高靶区勾画的一致性和可靠性。结论MRI和CT融合图像提供了互补的信息，有助于医师确定肿瘤边界，勾画出更精确的靶区，为精确放疗的实施奠定基础。

Objective To investigate the clinical value of CT/MRI fusion in the target contour of NPC IMRT. Methods We chose a NPC patient who treated by IMRT in this study. Then drawing the nasopharyngeal neoplasms in solo-CT images （GTVCT）and CT/MRI fusion images （GTVfusion） by 5 elder radiation oncology doctor. The variability of GTVcT was compared to GTVfusion in different doctor and the value of image fusion technique was evaluated in the target contour of NPC IMRT. Result GTVfusion was larger than GTVcT. In different doctor, the variability of GTVcT was larger than that of GTVfusion. Image fusion technique can obviously diminished the variability of target contour in different doctor. Conclusion CT/MRI fusion image can clearly define the tumor boundary. Image fusion technique can help doctor to contour the target volume in the precise radiotherapy.