本文選題：4DCT　切入點：形變配準(zhǔn)　出處：《濟南大學(xué)》2017年碩士論文

【摘要】：目的:研究應(yīng)用形變配準(zhǔn)技術(shù)聯(lián)合4DCT和MR-T2圖像進行肝癌IGTV制定的可行性,并分析該方法在HCC放療中的劑量學(xué)特點。方法:選擇2015-2016年間首次放療的HCC患者10例,依次完成自由呼吸下4DCT掃描,深吸氣狀態(tài)下MR-T2像掃描,將4DCT依呼吸時相分為10個序列。應(yīng)用MIM軟件進行圖像配準(zhǔn),評價指標(biāo)為門靜脈、腹腔干在三維方向的最大位移及肝臟交疊度。在各時相CT圖像上勾畫GTV,將4DCT各時相GTV融合為IGTV;將MR-T2圖像形變配準(zhǔn)到4DCT各時相圖像上,獲得10個GTVDR,并融合為IGTVDR。將IGTV與IGTVDR分別形變到CT00時相上,分別外擴安全邊界得到PTV和PTVDR,以在此相位圖像上進行放療計劃設(shè)計。配對t檢驗比較不同靶區(qū)體積和靶區(qū)、肝臟劑量差異。結(jié)果:門靜脈和腹腔干在x、y、z軸向位移分別為(0.3±0.8)、(0.5±1.5)、(0.7±1.2)mm和(0.8±1.8)、(0.1±1.0)、(0.6±2.0)mm。肝臟交疊度為(115.4±13.8)%。形變配準(zhǔn)后4DCT各時相GTV均大于配準(zhǔn)前,平均增加8.18%(P0.05),且各分時相形變后的GTV與MR-T2圖像中勾畫體積基本一致。IGTVDR顯著大于形變配準(zhǔn)前IGTV體積,平均增加了9.67%(P0.05)。形變配準(zhǔn)前PTV體積為626.76±494.12cm3,形變配準(zhǔn)后PTVDR體積為528.87±441.58cm3,體積小于形變配準(zhǔn)前,平均減少了15.65%。靶區(qū)D2、D98、D50、D95和CI、HI差異無統(tǒng)計學(xué)意義。形變配準(zhǔn)后肝臟V5、V10、V20、V30、V40和平均劑量(Dmean)受量均低于形變配準(zhǔn)前,分別降低5.92%、8.17%、8.04%、12.15%、9.98%和9.56%,差異有統(tǒng)計學(xué)意義。結(jié)論:MR圖像能顯示比CT更多的信息且表現(xiàn)出更高對比度。勾畫GTV時應(yīng)將MR圖像與4DCT圖像相結(jié)合,基于此獲得的IGTV可更好地確定靶區(qū)范圍和運動軌跡,提高肝癌靶區(qū)勾畫精度。由此形成的劑量分布可降低正常肝臟的受照劑量。
[Abstract]:Objective: to study the feasibility of using deformational registration technique combined with 4DCT and MR-T2 images in the formulation of liver cancer IGTV, and to analyze the dosimetric characteristics of this method in HCC radiotherapy. Methods: ten patients with HCC were selected for the first time in 2015-2016. The 4DCT was divided into 10 sequences according to the breathing phase. The image registration was carried out by MIM software. The evaluation index was portal vein, portal vein, portal vein, portal vein, portal vein, portal vein, portal vein, portal vein, portal vein, portal vein, portal vein, portal vein and so on. The maximum displacement of the celiac trunk in three dimensional direction and the degree of hepatic overlap. The GTV of each phase of 4DCT was fused to IGTV on CT images of each phase of 4DCT, and the deformation of MR-T2 images was registered to the images of each phase of 4DCT. Ten GTVDRs were obtained and fused to IGTV DR.The IGTV and IGTVDR were deformed to the CT00 phase respectively, and the PTV and PTVDRs were obtained by expanding the security boundary, respectively, for the design of radiotherapy plan on this phase image. T test was used to compare the different target volume and target area. Results: the axial displacement of portal vein and celiac trunk in xanyyong z was 0. 3 鹵0. 8 ~ 0. 5 鹵1. 5 ~ 0. 5 鹵0. 7 鹵1.2)mm and 0. 8 鹵1. 8 鹵1. 0 鹵1. 0 鹵2. 0 mmm. the degree of hepatic overlap was 11. 4 鹵13. 8. The GTV of each phase of 4DCT after deformation registration was higher than that before registration. The mean volume of GTV and MR-T2 images was basically the same. IGTVDR was significantly larger than that of IGTV before deformation registration. The volume of PTV before deformation registration is 626.76 鹵494.12 cm 3, and the volume of PTVDR after deformation registration is 528.87 鹵441.58 cm 3, which is smaller than that before deformation registration. There was no significant difference between the target area D2OD98 D50D95 and CIHI. After deformed registration, the liver V5 V10 V20 V20 V30 V40 and mean dose Dmean were lower than those before deformation registration. The difference is statistically significant. Conclusion GTV images can show more information than CT and show higher contrast. When drawing GTV, we should combine Mr images with 4DCT images. The obtained IGTV can better determine the target area and track of motion and improve the precision of drawing target area of liver cancer. The resulting dose distribution can reduce the radiation dose of normal liver.
【學(xué)位授予單位】：濟南大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R735.7;R730.55

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