MR与CT图像融合在三维适形放射治疗恶性胶质瘤靶区勾画中的应用

Research of MR and CT image registration in delineating malignant glioma using 3D-CRT

目的比较CT／MR图像融合与单纯CT勾画脑胶质瘤靶区的差异性，评价MRI与CT图像融合技术在恶性脑胶质瘤三维适形放射治疗靶区勾画中的准确性与优越性。方法选择本院2011-03—2014-03的29例脑胶质瘤患者，分别行头颅CT定位与MR定位采集图像，将两者所成图像进行融合，再分别勾画靶区，用计划系统制定三维适形放疗计划，并用剂量、体积直方图评价。选择GTV、CTV、PTV及OAR受量等指标进行统计学分析，分析MR与CT融合技术对恶性脑胶质瘤三维适形放射治疗计划影响。结果CT／MR图像融合勾画脑胶质瘤患者靶区可改变GTV与PTV，全组体积变化有统计学意义（P〈0．05）。结论应用CT／MR图像融合勾画恶性胶质瘤靶区较单纯利用CT定位图像勾画靶区更为准确，可减少脑胶质瘤靶区勾画的不确定性。

OBJECTIVE To find out the differences between CT/MR image registration and pure CT in delineating target volume of glioma and evaluate the accuracy and superiority of MR/CT image registration in curing malignant glioma using three-dimensional conformal radiation therapy. METHODS Twenty-nine glioma patients in our hospital received CT positioning and MR positioning respectively. Delineated the target area according to CT image and CT/MR fusion im- age respectively. Then made three-dimensional conformal radiation therapy using planning system and and evaluated the results using dose-volume histogram （DVH）. Chose GTV, CTV, PTV, OAR and other indexes to do statistical analysis and evaluated the advantages and disadvantages of the two plans and analyzed the effect of CT/MR image fusion on three- dimensional conformal radiation therapy when curing malignant glioma. RESULTS Using CT/MR image registration to delineate the target volume of gioma can change GTV and PTV. The changes of the whole team＇s volumes have statistical significance （P〈0.05）. CONCLUSIONS Using CT/MR image registration to delineate the target volume of malignant glioma is superior to that using pure CT positioning delineation. It decreases the uncertainty of the delineation of target volume of glioma.