Sixel Katharina E, Ruschin Mark, Tirona Romeo, Cheung Patrick C F
Toronto Sunnybrook Regional Cancer Centre, Toronto, ON, Canada.
Int J Radiat Oncol Biol Phys. 2003 Nov 1;57(3):717-23. doi: 10.1016/s0360-3016(03)00713-2.
To apply digital fluoroscopy integrated with CT simulation to measure lung tumor motion and aid in the quantification of individualized planning target volumes.
A flat panel digital fluoroscopy unit was modified and integrated with a CT simulator. The stored fluoroscopy images were overlaid with digitally reconstructed radiographs, allowing measurement of the observed lung tumor motion in relation to the corresponding contours on the static digitally reconstructed radiographs. CT simulation and digital fluoroscopy was performed on 10 patients with non-small-cell lung cancer. Actual tumor motion was measured in three dimensions using the overlaid images.
Combining the dynamic data with digitally reconstructed radiographs allowed the tumor shadow from the fluoroscopy to be tracked in relation to the CT lung tumor contour. For all patients, the extent of tumor motion in three dimensions was unique. The motion was greatest in the superoinferior direction and minimal in the AP and lateral directions.
We have developed a tool that allows CT simulation to be combined with digital fluoroscopy. Quantitative evaluation of the tumor motion in relation to the CT plan allows for customization of the planning target volume. The variability observed clearly demonstrates the need to generate patient-specific internal motion margins.
应用与CT模拟相结合的数字荧光透视法测量肺肿瘤运动，并辅助量化个体化计划靶体积。
对平板数字荧光透视设备进行改装，并与CT模拟器集成。将存储的荧光透视图像与数字重建射线照片叠加，从而能够测量观察到的肺肿瘤相对于静态数字重建射线照片上相应轮廓的运动。对10例非小细胞肺癌患者进行了CT模拟和数字荧光透视检查。使用叠加图像在三维空间中测量实际肿瘤运动。
将动态数据与数字重建射线照片相结合，可以追踪荧光透视中的肿瘤阴影相对于CT肺肿瘤轮廓的情况。对于所有患者，肿瘤在三维空间中的运动范围是独特的。运动在上下方向最大，在前后和左右方向最小。
我们开发了一种工具，可将CT模拟与数字荧光透视相结合。对肿瘤相对于CT计划的运动进行定量评估有助于定制计划靶体积。观察到的变异性清楚地表明需要生成患者特异性的内部运动边界。
