Shen Sui, Jacob Rojymon, Bender Luvenia W, Duan Jun, Spencer Sharon A
Department of Radiation Oncology, University of Alabama at Birmingham, Birmingham, AL.
Department of Radiation Oncology, University of Alabama at Birmingham, Birmingham, AL.
Med Dosim. 2014 Spring;39(1):7-11. doi: 10.1016/j.meddos.2013.08.006. Epub 2013 Oct 3.
Radiotherapy or stereotactic body radiosurgery (SBRT) requires a sufficient functional liver volume to tolerate the treatment. The current study extended the work of de Graaf et al. (2010) [3] on the use of (99m)Tc-mebrofenin imaging for presurgery planning to radiotherapy planning for liver cancer or metastases. Patient was immobilized and imaged in an identical position on a single-photon emission computed tomography/computed tomography (SPECT-CT) system and a radiotherapy simulation CT system. (99m)Tc-mebrofenin SPECT was registered to the planning CT through image registration of noncontrast CT from SPECT-CT system to the radiotherapy planning CT. The voxels with higher uptake of (99m)Tc-mebrofenin were transferred to the planning CT as an avoidance structure in optimizing a 2-arc RapidArc plan for SBRT delivery. Excellent dose coverage to the target and sparing of the healthy remnant liver volume was achieved. This report illustrated a procedure for the use of (99m)Tc-mebrofenin SPECT for optimizing radiotherapy for liver cancers and metastases.
放射治疗或立体定向体部放射治疗（SBRT）需要足够的功能性肝体积来耐受治疗。当前研究扩展了de Graaf等人（2010年）[3]关于使用（99m）锝-美罗芬宁成像进行术前规划至肝癌或转移瘤放射治疗规划的工作。患者在单光子发射计算机断层扫描/计算机断层扫描（SPECT-CT）系统和放射治疗模拟CT系统上以相同体位固定并成像。通过将SPECT-CT系统的非增强CT与放射治疗规划CT进行图像配准，将（99m）锝-美罗芬宁SPECT配准到规划CT上。（99m）锝-美罗芬宁摄取较高的体素被转移到规划CT上，作为一种避让结构，用于优化SBRT实施的双弧 RapidArc计划。实现了对靶区的良好剂量覆盖以及对健康残余肝体积的保护。本报告阐述了使用（99m）锝-美罗芬宁SPECT优化肝癌和转移瘤放射治疗的流程。
