四维锥形束计算机断层扫描引导下的胃淋巴瘤放射治疗
Four-dimensional cone-beam computed tomography-guided radiotherapy for gastric lymphoma.
作者信息
Toya Ryo, Saito Tetsuo, Shimohigashi Yoshinobu, Yotsuji Yohei, Matsuyama Tomohiko, Watakabe Takahiro, Kai Yudai, Yamashita Yasuyuki, Oya Natsuo
机构信息
Department of Radiation Oncology, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.
Department of Radiological Technology, Kumamoto University Hospital, Kumamoto, Japan.
出版信息
Jpn J Radiol. 2018 Feb;36(2):159-163. doi: 10.1007/s11604-017-0698-8. Epub 2017 Oct 30.
PURPOSE
We describe a treatment method with four-dimensional cone-beam computed tomography (4D-CBCT)-guided radiotherapy for gastric lymphoma.
MATERIALS AND METHODS
We performed image-guided radiotherapy (IGRT) with 15 fractions for a gastric mucosa-associated lymphoid tissue lymphoma patient, using 4D-CBCT. The stomach was delineated based on 4D-CT images. For image guidance, an automatic registration between planning CT and 4D-CBCT images was performed based on the bony anatomy (bone matching), followed by manual registration based on the stomach in 4D-CBCT images of all 10 phases (4D matching). We calculated the covering ratio (CR) with variable stomach-to-planning target volume (PTV) margins, based on the images of all phases [CR (%) = the number of covering phases/all 150 phases × 100].
RESULTS
The patient underwent radiotherapy (RT) as scheduled, without any significant adverse effects. The appropriate PTV margins (CR ≥ 95%) were 25 mm (CR 99.3%) and 15 mm (CR 98.7%) for bone and 4D matching, respectively.
CONCLUSION
4D matching using 4D-CBCT is appropriate for IGRT of gastric lymphomas.
目的
我们描述一种采用四维锥形束计算机断层扫描（4D-CBCT）引导的放射治疗胃淋巴瘤的方法。
材料与方法
我们对一名胃黏膜相关淋巴组织淋巴瘤患者使用4D-CBCT进行了15次分割的图像引导放射治疗（IGRT）。基于4D-CT图像勾勒出胃部轮廓。为了进行图像引导，首先基于骨骼解剖结构（骨匹配）在计划CT和4D-CBCT图像之间进行自动配准，然后在所有10个时相的4D-CBCT图像中基于胃部进行手动配准（4D匹配）。我们根据所有时相的图像计算了不同胃到计划靶体积（PTV）边界情况下的覆盖率（CR）[CR（%）=覆盖时相数/所有150个时相数×100]。
结果
患者按计划接受了放射治疗（RT），未出现任何明显不良反应。对于骨匹配和4D匹配，合适的PTV边界（CR≥95%）分别为25 mm（CR 99.3%）和15 mm（CR 98.7%）。
结论
使用4D-CBCT进行4D匹配适用于胃淋巴瘤的IGRT。
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