Soda Itaru, Ishiyama Hiromichi, Ono Shigemitsu, Takenaka Kouji, Arai Masahide, Arai Tsutomu, Iwase Haruko, Sekiguchi Akane, Kawakami Shogo, Komori Shouko, Onda Takashi, Hayakawa Kazushige
Department of Radiology and Radiation Oncology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minamiku, Sagamihara, Kanagawa 252-0374, Japan
Department of Radiology and Radiation Oncology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minamiku, Sagamihara, Kanagawa 252-0374, Japan.
J Radiat Res. 2015 Mar;56(2):354-9. doi: 10.1093/jrr/rru116. Epub 2015 Jan 14.
The purpose of this study was to analyze transposed ovarian movement. Data from 27 patients who underwent ovarian transposition after surgical treatment for uterine cancer were retrospectively analyzed. Computed tomography (CT) images including transposed ovaries were superimposed on other CT images acquired at different times, and were matched on bony structures. Differences in ovarian position between the CT images were measured. The planning organ at risk volume (PRV) margins were calculated from the formula of the 90% reference intervals (RIs) and the 95% RI, which were defined as mean ± 1.65 standard deviation (SD) and mean ± 1.96 SD, respectively. The 90% RI in the cranial, caudal, anterior, posterior, left and right directions were 1.5, 1.5, 1.4, 1.0, 1.7 and 0.9 cm, respectively. The 95% RI in the corresponding directions were 1.5, 2.0, 1.7, 1.2, 1.9 and 1.2 cm, respectively. These data suggest that bilateral ovaries need a PRV margin of ∼2 cm in all directions. The present study suggests that a transposed ovary needs the same PRV margin as a normal ovary (∼2 cm). Even after transposition, ovaries should be kept away from the radiation field to take into consideration the degree of ovarian movement.
本研究的目的是分析移位卵巢的移动情况。对27例子宫癌手术治疗后行卵巢移位术的患者数据进行回顾性分析。将包括移位卵巢的计算机断层扫描（CT）图像与在不同时间获取的其他CT图像进行叠加，并在骨骼结构上进行匹配。测量CT图像之间卵巢位置的差异。根据90%参考区间（RIs）和95% RI的公式计算计划危及器官体积（PRV）边界，90% RI和95% RI分别定义为均值±1.65标准差（SD）和均值±1.96 SD。在头侧、尾侧、前侧、后侧、左侧和右侧方向的90% RI分别为1.5、1.5、1.4、1.0、1.7和0.9 cm。相应方向的95% RI分别为1.5、2.0、1.7、1.2、1.9和1.2 cm。这些数据表明双侧卵巢在各个方向都需要约2 cm的PRV边界。本研究表明，移位卵巢需要与正常卵巢相同的PRV边界（约2 cm）。即使在移位后，考虑到卵巢的移动程度，卵巢也应远离辐射野。
