Department of Radiation Oncology, Centro di Riferimento Oncologico, CRO, Via F. Gallini 2, 33081, Aviano (PN), Italy,
Radiol Med. 2013 Oct;118(7):1212-9. doi: 10.1007/s11547-013-0967-2. Epub 2013 Jul 25.
This study was undertaken to study the role of fiducial markers for image-guided partial breast irradiation (IG-PBI), and to compare the shifts based on bony anatomy and fiducial markers.
Fifteen patients underwent IGPBI. Three fiducial markers were placed in the tumour bed at the time of surgery. Daily orthogonal anterior/ posterior and lateral kV-images were taken before each fraction and compared with the digitally-reconstructed radiographs, both using bony landmarks and fiducial markers as reference. The Student's t test was used to detect a meaningful difference of 3 mm in between the two methods.
A total of 105 image-guided radiation therapy (IGRT) sessions were obtained. The mean superior/inferior, right/left, and anterior/posterior shifts obtained using the bony landmarks vs. the fiducial markers were 2 mm [standard deviation (SD) 10 mm] vs. 0 mm (SD 7 mm), 0 mm (SD 7 mm) vs. 1 mm (SD 4 mm), and 1 mm (SD 7 mm) vs. 0 mm (SD 5 mm), respectively. The mean shift differences in absolute value between the two methods, along the superior/inferior, right/left and anterior/posterior directions were 5 mm (p=0.001), 3 mm [p=not significant (ns)], and 3 mm (p=ns), respectively.
Fiducial markers for IG-PBI increase set-up accuracy compared to the bony landmarks, in particular along the superior/inferior direction.
本研究旨在探讨在图像引导部分乳腺照射（IG-PBI）中应用基准标记物的作用，并比较基于骨性解剖结构和基准标记物的摆位误差。
共 15 例患者接受了 IG-PBI。在手术时于肿瘤床内放置了 3 个基准标记物。在每次治疗前，均会拍摄前-后位和侧位的千伏级 X 线图像，并与数字重建射线照相（DRR）进行比较，两者均以骨性解剖标志和基准标记物作为参考。使用学生 t 检验来检测两种方法之间 3mm 有意义的差异。
共获得 105 次图像引导放疗（IGRT）治疗。使用骨性解剖标志和基准标记物获得的上/下、右/左和前/后方向的平均移位分别为 2mm（标准差 10mm）比 0mm（标准差 7mm）、0mm（标准差 7mm）比 1mm（标准差 4mm）和 1mm（标准差 7mm）比 0mm（标准差 5mm）。两种方法之间的绝对移位差值的平均值沿上/下、右/左和前/后方向分别为 5mm（p=0.001）、3mm（p=无统计学意义（ns））和 3mm（p=ns）。
与骨性解剖结构相比，IG-PBI 中的基准标记物可提高摆位精度，特别是在上/下方向。
