一种基于每日肺部立体定向放疗锥形束CT图像评估早期肿瘤反应的新方法。

A Novel Method for Evaluating Early Tumor Response Based on Daily CBCT Images for Lung SBRT.

作者信息

Luo Wei, Xiu Zijian, Wang Xiaoqin, McGarry Ronald, Allen Joshua

机构信息

Department of Radiation Medicine, University of Kentucky, 800 Rose Street, Lexington, KY 40536, USA.

Department of Radiology, University of Kentucky, 800 Rose Street, Lexington, KY 40536, USA.

出版信息

Cancers (Basel). 2023 Dec 19;16(1):20. doi: 10.3390/cancers16010020.

BACKGROUND

We aimed to develop a new tumor response assessment method for lung SBRT.

METHODS

In total, 132 lung cancer patients with 134 tumors who received SBRT treatment with daily CBCT were included in this study. The information about tumor size (area), contrast (contrast-to-noise ratio (CNR)), and density/attenuation (μ) was derived from the CBCT images for the first and the last fractions. The ratios of tumor area, CNR, and μ (R, R, R) between the last and first fractions were calculated for comparison. The product of the three rations was defined as a new parameter (R) for assessment. Tumor response was independently assessed by a radiologist based on a comprehensive analysis of the CBCT images.

RESULTS

R ranged from 0.27 to 1.67 with a mean value of 0.95. Based on the radiologic assessment results, a receiver operation characteristic (ROC) curve with the area under the curve (AUC) of 95% was obtained and the optimal cutoff value (R) was determined as 1.1. The results based on R achieved a 94% accuracy, 94% specificity, and 90% sensitivity.

CONCLUSION

The results show that R was correlated with early tumor response to lung SBRT and that using R for evaluating tumor response to SBRT would be viable and efficient.

背景

我们旨在开发一种用于肺部立体定向体部放疗（SBRT）的新肿瘤反应评估方法。

方法

本研究纳入了132例患有134个肿瘤且接受每日锥形束CT（CBCT）引导下SBRT治疗的肺癌患者。肿瘤大小（面积）、对比度（对比噪声比（CNR））和密度/衰减（μ）的信息来自首次和末次分割时的CBCT图像。计算末次与首次分割时肿瘤面积、CNR和μ的比值（R、R、R）以进行比较。将这三个比值的乘积定义为一个新的评估参数（R）。由一名放射科医生基于对CBCT图像的综合分析独立评估肿瘤反应。