4D-CT在射波刀治疗肺部肿瘤中的应用

Application of 4D-CT in CyberKnife for Lung Tumor

目的:用4D-CT来确定患者肺部肿瘤三维方向上的运动矢量,作为射波刀治疗中PTV外放的参考。方法:采用PHILIPS Brilliace Big Bore 16排螺旋CT在Pulmo RETRO 4D模式下分别对11例肺部肿瘤患者进行10个时相图像扫描,通过Tumor LOC电影模式测量肿瘤三维方向上运动矢量的大小。结果:通过上述方法已将运动度小于5 mm的3例上肺患者、1例右中肺患者、1例右下肺患者应用到射波刀治疗。结论:用4D-CT来确定肿瘤三维运动的范围,通过适当的外放形成PTV,采用X-Sight Spine跟踪软件,可以解决部分未能植入金标且不能用X-Sight Lung的肺部肿瘤患者。

To determine the motion vectors of lung tumors in three-dimensional direction with 4D-CT to provide CyberKnife treatment reference for PTV margin. ~ Eleven cases of lung cancer patients were scanned with PHILIPS Brilliance Big Bore 16-slice spiral CT in Pulmo RETRO 4D mode with 10-phase images. The motion vectors and sizes of lung tumors were measured in Tumor LOC movie mode. ~ A total of 5 cases with movement less than 5mm in three- dimensional direction, including 3 cases with upper lung cancer, 1 case of right-lower lung cancer and 1 case of right- middle lung cancer, were treated with CyberKnife using X-Sight Spine tracking. By using 4D-CT to determine the scope of the tumor three-dimensional movement and enlarging the GTV to PTV, some patients with lung tumors can be treated with CyberKnife by X-Sight Spine tracking, who are incompatible to gold seeds implantation or X-Sight Lung tracking.