实用肿瘤杂志2017，Vol.32Issue(5)：444-449,6.
四维与三维CT模拟定位确定食管癌原发肿瘤靶区位移和体积的比较研究
Comparison of 4D-CT and 3D-CT simulation in determining displacement and target volume of primary esophageal carcinoma
摘要
Abstract
Objective To compare the four-dimensional and three-dimensional computed tomography (4D-CT and 3D-CT) simulation technology in determining the displacement and internal gross target volume of primary esophageal carcinoma.Methods Twenty-two pathologically diagnosed esophageal cancer patients planning to receive intensity modulated radiation therapy (IMRT) were prospectively recruited and sequentially received contrast enhancement free-breathing 3D-CT and respiration-synchronized 4D-CT simulation examinations.Three different internal gross tumor target volume (IGTV) planning methods of esophageal cancer were delineated:all 10 respiratory phases from 4D-CT were merged as IGTV4D,only end-inhalation and end-exhalation phases were considered as IGTV4D'and the IGTV3D was acquired by enlarging the 3D-CT-based GTV with the consideration of spatial motion on three orthogonal directions from 4D-CT.Then the target volume and the displacement on three orthogonal directions of these three different IGTV (including IGTV4D'IGTV4D'and IGTV3D) were compared.The dice similarity coefficient (DSC) and overlap index (OI) between IGTV4D and IGTV4D',and between IGTV4D and IGTV3D for different segments of esophagus were also calculated.Results Statistically significant differences were detected for displacement at left-right,anterior-posterior and superior-inferior directions of primary esophageal tumor GTV of the 10 phases originated from medium-thoractic segments and medium-lower-thoractic segments (both P ＜ 0.01).Besides,the primary tumor volume was also significantly different:IGTV3D ＞ IGTV4D ＞ IGTV4D'(P ＜ 0.05).With IGTV4D as the assumed gold standard,IGTV3D may lead to unnecessary radiation of 9.1％ to 24.1％ of the surrounding normal tissues,whereas IGTV4D'may result in 10.5％ to 34.5％ of target area being uncovered.Conclusion 4D-CT simulation technology is superior to 3D-CT simulation technology for IMRT in esophageal carcinoma.关键词
食管肿瘤/立体定位技术/体层摄影术,X线计算机Key words
esophageal neoplasms/stereotaxic techniques/tomography, X-ray computed分类
医药卫生引用本文复制引用
赖国静,李建成,潘才住,胡彩容,郑德春..四维与三维CT模拟定位确定食管癌原发肿瘤靶区位移和体积的比较研究[J].实用肿瘤杂志,2017,32(5):444-449,6.基金项目
国家临床重点专科建设项目(2014) （2014）
福建省临床重点专科建设项目(2013) （2013）
