图像引导放射治疗技术提高腹部肿瘤放射治疗精度的临床分析

Clinical Analysis of Image-guided Radiotherapy to Improve Accuracy of Abdominal Tumor Radiotherapy

目的分析探讨图像引导放射治疗技术提高腹部肿瘤放射治疗精度的临床效果。方法对2019年12月-2020年5月在六安市人民医院放射科接受图像引导放射治疗技术的18例腹部肿瘤患者临床资料进行回顾性分析,采用锥形束CT影像技术获取患者的x(左右)、y(头脚)、z(前后)方向的线性摆位误差,并分别以x、y、z轴旋转获取相对应的u、v、w旋转摆位误差。结果18例腹部肿瘤患者共接受320次锥形束CT影像技术检测,x、y、z、u、v、w轴自由度的系统误差、随机误差分别为(0.15±0.04)cm、(0.06±0.12)cm、(﹣0.02±0.10)cm、(0.74±0.21)°、(﹣0.21±0.24)°、(0.21±0.17)°。通过数据比对可以发现,摆位误差y>z>x,x、y、z的摆位外扩分别为0.603cm、0.179cm、0.42cm。结论为进一步减少摆位误差,治疗时建议临床将靶体积(CTV)外放计划靶体积(PTV)时,分别将x、y、z外扩0.606cm、0.182cm、0.54cm。

Objective To analyze clinical effect of image-guided radiotherapy in improving accuracy of abdominal tumor radiotherapy.Methods The paper reveiwed and analyzed clinical data of 18 patients with abdominal tumors received image-guided radiotherapy in radiology department of Lu'an City People's Hospital from December 2019 to May 2020,linear positioning errors in x(left and right),y(head and foot),x(front and back)directions were obtained by cone beam CT imaging technology,and corresponding u,v,w rotation positioning errors were obtained by x,y,z axis rotation respectively.Results 18 cases with abdominal tumors received 320 times of cone beam CT imaging,systematic error and random error of degrees of freedom of x,y,z,u,v and w axes were(0.15±0.04)cm,(0.06±0.12)cm,(-0.02±0.10)cm,(0.74±0.21)°,(-0.21±0.24)°,(0.21±0.17)°,respectively.Data comparison showed that positioning error y>z>x,and positioning spread of x,y and z was 0.603cm,0.179cm and 0.42cm respectively.Conclusion To further reduce positioning error,it is suggested that CTV should be placed outside the planned PTV,and x,y and z should be expanded by 0.606cm,0.182cm and 0.54cm respectively.