本文選題：4DCT　切入點(diǎn)：形變配準(zhǔn)　出處：《濟(jì)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(jìn)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(diǎn)。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(shí)相分為10個(gè)序列。應(yīng)用MIM軟件進(jìn)行圖像配準(zhǔn),評(píng)價(jià)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(shí)相CT圖像上勾畫GTV,將4DCT各時(shí)相GTV融合為IGTV;將MR-T2圖像形變配準(zhǔn)到4DCT各時(shí)相圖像上,獲得10個(gè)GTVDR,并融合為IGTVDR。將IGTV與IGTVDR分別形變到CT00時(shí)相上,分別外擴(kuò)安全邊界得到PTV和PTVDR,以在此相位圖像上進(jìn)行放療計(jì)劃設(shè)計(jì)。配對(duì)t檢驗(yàn)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(shí)相GTV均大于配準(zhǔn)前,平均增加8.18%(P0.05),且各分時(shí)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(jì)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(jì)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(duì)比度。勾畫GTV時(shí)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(yùn)動(dòng)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(jì)南大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R735.7;R730.55

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 雷懷宇;張書旭;張國前;彭瑩瑩;王銳濠;蔣紹惠;周祥;;宮頸癌患者放療過程中靶區(qū)體積及位移變化[J];廣東醫(yī)學(xué);2015年16期

2 徐華;鞏貫忠;陳進(jìn)琥;尚東平;劉同海;朱健;盧潔;;基于形變配準(zhǔn)獲得的強(qiáng)化4DCT制定肝癌個(gè)體化IGTV可行性研究[J];中華放射腫瘤學(xué)雜志;2015年03期

3 侯棟梁;房彤;劉輝;王亞寧;劉博;;CT/MR圖像融合在食管癌精確放療大體腫瘤靶區(qū)勾畫中的應(yīng)用價(jià)值[J];中華放射醫(yī)學(xué)與防護(hù)雜志;2014年02期

4 王瀾;韓春;祝淑釵;時(shí)高峰;王琦;黨榮廣;田華;孔潔;張安度;;磁共振彌散加權(quán)成像在食管癌放療療效評(píng)價(jià)中的應(yīng)用價(jià)值探討[J];中華放射醫(yī)學(xué)與防護(hù)雜志;2014年02期

5 邢軍;李建彬;張英杰;李鳳祥;范廷勇;徐敏;尚東平;韓建軍;;四維CT中三種方法勾畫原發(fā)性肝癌內(nèi)大體靶體積的比較研究[J];中華腫瘤雜志;2012年02期

6 馬長升;尹勇;劉同海;陳進(jìn)琥;孫濤;林秀桐;;旋轉(zhuǎn)調(diào)強(qiáng)與固定野調(diào)強(qiáng)治療肝癌的劑量學(xué)比較[J];中華放射醫(yī)學(xué)與防護(hù)雜志;2010年05期

7 劉翔宇;柳先鋒;尹文娟;何亞男;;電子射野影像系統(tǒng)在放療中的質(zhì)量保證應(yīng)用[J];中國醫(yī)學(xué)物理學(xué)雜志;2010年05期

8 袁雙虎;于金明;于甬華;楊新華;付政;楊國仁;郭洪波;王曉航;周英智;陳少卿;;~(18)F-脫氧葡萄糖PET-CT檢測食管癌病變長度的臨床價(jià)值[J];中華放射腫瘤學(xué)雜志;2006年05期

9 于甬華,羅立民,李寶生,于金明 ,梁超前 ,趙月環(huán);呼吸運(yùn)動(dòng)對(duì)肝部占位性病灶位置的影響及數(shù)學(xué)模型的建立[J];中華放射腫瘤學(xué)雜志;2002年04期

10 習(xí)勉;劉孟忠;鄧小武;張黎;黃曉延;蔡玲;;基于四維CT原發(fā)性肝癌內(nèi)靶體積的確定及劑量學(xué)研究[J];中華放射腫瘤學(xué)雜志;2009年06期

，

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