医疗卫生装备2025，Vol.46Issue(3)：54-58,5.DOI:10.19745/j.1003-8868.2025048
左侧乳腺癌深吸气屏气放疗中心脏亚结构运动的量化分析
Quantitative analysis of motion of cardiac substructures in deep inspiratory breath holding radiotherapy for left breast cancer
摘要
Abstract
Objective To quantify the volume and movement of cardiac substructures by using coronary computed tomography angiography(CCTA)to provide guidance for the design of deep inspiratory breath-holding radiation therapy for left breast cancer and the protection of organs at risk.Methods Totally 18 female patients who received conventional chest plain scan and CCTA were selected to simulate the design process of radiotherapy plan for left breast cancer patients with internal mammary lymph nodes.Retrospective reconstruction of CCTA data was performed for each patient,with 10 phase images(with an interval of 10％)within a R-R cardiac cycle(10％-100％)to simulate the true range of motion of the heart.The heart,left atrium(LA),left ventricle(LV),right atrium(RA),right ventricle(RV),left anterior descending artery(LAD),left circumflex coronary artery(LCX)and right coronary artery(RCA)were contoured at each phase.The distances from the centroid position to the average position of LAD,LCX and RCA were measured at each phase in the superior-inferior(SI),anterior-posterior(AP)and left-right(LR).The average volume and range of volume changes of LA,LV,RA,RV and heart were analyzed within a cardiac cycle.The expansion margins of planning organs at risk volume(PRV)were calculated.SPSS 19.0 software was used for statistical analysis.Results The following average absolute displacements were found in SI,AP and LR coordinates:(1.8±0.7)mm,(1.2±0.5)mm and(1.5±0.5)mm for LAD,respectively;(2.1±0.7)mm,(1.5±0.6)mm and(1.9±0.7)mm for LCX,respectively;(1.6±0.5)mm,(2.2±0.9)mm and(2.2±0.8)mm for RCA,respectively.The volume changes of LA,LV,RA,RV and heart within a cardiac cycle ranged from 34.3 to 63.9 cm3,122.1 to 154.3 cm3,29.3 to 53.6 cm3,57.2 to 94.3 cm3 and 480.1 to 515.4 cm3,respectively.The theoretical expansion margins of LAD,LCX and RCA in all the three directions were within 2 mm.Conclusion The ranges of movement and volume changes of cardiac substructure are quantitati-vely displayed,and references are provided for the planning of deep inspiratory breath-holding radiation therapy for left breast cancer and the protection of organs at risk.[Chinese Medical Equipment Journal,2025,46(3):54-58]关键词
乳腺癌/深吸气屏气/放疗/心脏亚结构/冠状动脉CT血管造影Key words
breast cancer/deep inspiration breath holding/radiotherapy/cardiac substructure/coronary computed tomogra-phy angiography分类
医药卫生引用本文复制引用
汤朝晖,张哲,毛玮斌,黄波,艾俊峰,朱超凡,谢植超,刘雅洁..左侧乳腺癌深吸气屏气放疗中心脏亚结构运动的量化分析[J].医疗卫生装备,2025,46(3):54-58,5.基金项目
深圳市医疗卫生三名工程项目(SZSM202211036) （SZSM202211036）
