使用 3T MRI 进行立体定向靶定位的放射外科计划的临床评估。
Clinical evaluation of stereotactic target localization using 3-Tesla MRI for radiosurgery planning.
机构信息
University of Toronto Faculty of Medicine, Toronto, ON, Canada.
出版信息
Int J Radiat Oncol Biol Phys. 2010 Apr;76(5):1472-9. doi: 10.1016/j.ijrobp.2009.03.020. Epub 2009 Jun 8.
PURPOSE
Increasing the magnetic resonance imaging (MRI) field strength can improve image resolution and quality, but concerns remain regarding the influence on geometric fidelity. The objectives of the present study were to spatially investigate the effect of 3-Tesla (3T) MRI on clinical target localization for stereotactic radiosurgery.
METHODS AND MATERIALS
A total of 39 patients were enrolled in a research ethics board-approved prospective clinical trial. Imaging (1.5T and 3T MRI and computed tomography) was performed after stereotactic frame placement. Stereotactic target localization at 1.5T vs. 3T was retrospectively analyzed in a representative cohort of patients with tumor (n = 4) and functional (n = 5) radiosurgical targets. The spatial congruency of the tumor gross target volumes was determined by the mean discrepancy between the average gross target volume surfaces at 1.5T and 3T. Reproducibility was assessed by the displacement from an averaged surface and volume congruency. Spatial congruency and the reproducibility of functional radiosurgical targets was determined by comparing the mean and standard deviation of the isocenter coordinates.
RESULTS
Overall, the mean absolute discrepancy across all patients was 0.67 mm (95% confidence interval, 0.51-0.83), significantly <1 mm (p < .010). No differences were found in the overall interuser target volume congruence (mean, 84% for 1.5T vs. 84% for 3T, p > .4), and the gross target volume surface mean displacements were similar within and between users. The overall average isocenter coordinate discrepancy for the functional targets at 1.5T and 3T was 0.33 mm (95% confidence interval, 0.20-0.48), with no patient-specific differences between the mean values (p >.2) or standard deviations (p >.1).
CONCLUSION
Our results have provided clinically relevant evidence supporting the spatial validity of 3T MRI for use in stereotactic radiosurgery under the imaging conditions used.
目的
提高磁共振成像（MRI）场强可以提高图像分辨率和质量，但人们仍然担心这会对几何保真度产生影响。本研究的目的是空间研究 3 特斯拉（3T）MRI 对立体定向放射外科的临床靶区定位的影响。
方法和材料
共有 39 名患者参加了一项经机构审查委员会批准的前瞻性临床试验。在立体定向框架放置后进行影像学检查（1.5T 和 3T MRI 和计算机断层扫描）。对 4 例肿瘤和 5 例功能（立体定向）放射外科靶区的代表性患者队列进行了 1.5T 与 3T 立体定向靶区定位的回顾性分析。肿瘤大体靶区的空间一致性通过 1.5T 和 3T 平均大体靶区表面之间的平均差异来确定。通过从平均表面和体积一致性的位移来评估可重复性。通过比较等中心点坐标的平均值和标准差来确定功能放射外科靶区的空间一致性和可重复性。
结果
总体而言，所有患者的平均绝对差异为 0.67 毫米（95%置信区间，0.51-0.83），明显小于 1 毫米（p<0.010）。在总体用户间靶区体积一致性方面没有差异（平均值，1.5T 为 84%，3T 为 84%，p>0.4），并且用户内和用户间的大体靶区表面平均位移相似。1.5T 和 3T 时功能靶区的总体平均等中心点坐标差异为 0.33 毫米（95%置信区间，0.20-0.48），患者间平均值（p>0.2）或标准差（p>0.1）无差异。
结论
我们的结果提供了临床相关证据，支持在使用的成像条件下，3T MRI 在立体定向放射外科中的空间有效性。
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