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螺旋断层放疗系统MVCT分析儿童髓母细胞瘤中不同定位方式的摆位误差
作者:祝敏  蒋帅君  蒋马伟 
单位:上海市交通大学医学院附属新华医院肿瘤科  上海 200092 
关键词:髓母细胞瘤/放射疗法 放射治疗剂量 粒子加速器 放射治疗计划 计算机辅助 体层摄影术 螺旋计算机 俯卧位 仰卧位 回顾性研究 
DOI:R730.55
出版年,卷(期):页码:2018,33(1):73-75
摘要:

目的 应用螺旋断层放疗系统兆伏级螺旋断层(megavoltage computed tomography,MVCT)图像研究儿童髓母细胞瘤放疗不同定位方式的摆位误差。方法 回顾性分析21例接受螺旋断层放疗系统放疗的儿童髓母细胞瘤患者,其中8例采取俯卧位定位固定,13例采取仰卧位定位固定。两组患者治疗前均行MVCT扫描,MVCT扫描图像与计划CT图像进行配准。比较分析两组在各个方向上的摆位误差。结果 俯卧位定位固定头颈部X、YZ轴方向上的摆位误差分别为(1.97±1.66)mm、(2.52±1.76)mm和(6.04±3.82)mm,腰椎部X、YZ轴方向上的摆位误差分别为(4.15±2.66)mm、(5.29±3.53)mm和(5.84±4.75)mm。仰卧位定位固定X、YZ轴方向上的头颈部摆位误差分别为(1.44±1.37)mm、(2.17±1.73)mm和(3.05±2.19)mm,腰椎部X、YZ轴方向上的摆位误差分别为(2.78±1.96)mm、(2.97±1.80)mm和(3.49±2.91)mm。两组头颈部摆位误差在XZ轴方向上比较,差异均具有统计学意义(均P<0.05);腰椎部摆位误差在X、YZ轴方向上比较,差异均具有统计学意义(均P<0.05)。俯卧位定位固定的腰椎部相对头颈部的误差在X、YZ轴方向上分别为(4.63±3.01)mm、(4.23±2.93)mm和(5.31±4.89)mm,仰卧位定位固定的腰椎部相对头颈部的摆位误差在X、YZ轴方向上分别为(2.90±2.14)mm、(2.43±2.00)mm和(3.57±2.77)mm。两组摆位误差在X、YZ轴方向上比较,差异均具有统计学意义(均P<0.05)。结论 髓母细胞瘤患者采用仰卧位定位固定比俯卧位定位固定摆位精确性和重复性更好。

Objective To analyze the setup errors of different body position fixing methods for radiotherapy by megavoltage computed tomography (MVCT) in pediatric medulloblastoma. Methods Twenty-one patients of pediatric medulloblastoma treated with helical tomotherapy were retrospectively analyzed. Eight patients were fixed in the prone position and 13 patients were fixed in the supine position. All cases received MVCT scan before the treatment. Then the MVCT images were matched to the planning CT images,and the setup errors were compared for the two fixing methods in all directions. Results For the prone position,the setup errors of the head and neck were (1.97±1.66)mm,(2.52±1.76)mm,and (6.04±3.82)mm on the X,Y and Z axis,respectively; the setup errors of the lumbar vertebrae on the X,Y and Z axis were (4.15±2.66)mm,(5.29±3.53)mm,and (5.84±4.75)mm. For the supine position on 365bet娱乐官网网址the X,Y and Z axis,the setup errors were (1.44±1.37)mm,(2.17±1.73)mm and (3.05±2.19)mm for the head and neck, and were (2.78±1.96)mm,(2.97±1.80)mm and (3.49±2.91)mm for the lumbar vertebrae. Significant differences of setup errors were observed in the X and Z axis for the head and neck (both P<0.05),and in all three axis for the lumbar vertebrae (all P<0.05),between the prone position fixing and the supine position fixing methods. Moreover,the setup errors of lumbar vertebrae relative to head and neck were (4.63±3.01)mm,(4.23±2.93)mm and (5.31±4.89)mm for the prone position,and were (2.90±2.14)mm,(2.43±2.00)mm and (3.57±2.77)mm for the supine position on the X,Y and Z axis (all P<0.05). Conclusion Both the precision and repeatability of supine position fixing method were superior than those of the prone position fixing method for helical tomotherapy in pediatric medulloblastoma patients.

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