Qiao Wei, Li Yue, Guo Chang, Shen Zhiyuan, Jiang Minghua, Liu Jianyao, Yin Ping, Xiao Shuyue, Gong Zhen, Xu Hanzi, Feng Yong
Department of Radiology, The Affiliated Cancer Hospital of Nanjing Medical University & Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research, Nanjing, 210009, China.
Department of Radiation Oncology, The Affiliated Cancer Hospital of Nanjing Medical University & Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research, Nanjing, 210009, China.
BMC Med Imaging. 2025 Jul 29;25(1):301. doi: 10.1186/s12880-025-01840-9.
This study compared the outcomes of modified three-dimensional printed non-coplanar templates (3DPNCT) with those of conventional 3DPNCT for iodine-125 (I) seed implantation in malignant tumors and analyzed associated technical differences.
We analyzed patients with malignant tumors undergoing I seed implantation in our department from February 2021 to May 2023. Cases using modified 3DPNCT guidance comprised the experimental group, while those using conventional 3DPNCT formed the control group. All patients underwent identical computed tomography (CT) scanning, preoperative planning, and 3D-printed template creation protocols. The experimental group featured modifiable guide posts enabling intraoperative needle angle/direction adjustments. Pre- and postoperative planning target volume (PTV) and dosimetric parameters included D, D, V, V, conformity index (CI), external index (EI), and homogeneity index (HI) were compared intra- and inter-group.
A total of 70 patients were enrolled, including 35 in the experimental group and 35 in the control group. In the experimental group, pre- and post-operation values for PTV, D, CI and EI, were 61.4(24.9,106.6)cc and 61.6(24.9,106.7)cc, (71.9 ± 16.77) Gy and (65.6 ± 18.0)Gy, 0.7615(0.7102,0.7941) and 0.7780(0.7214,0.8172), 19.0(14.8,25.6)% and 16.1(13.0,28.0)%, respectively, showing a statistically significant difference (P < 0.05). The PTV, D, D, V, CI, EI and HI values before and after the operation in the control group were (69.0 ± 55.0)cc and (69.1 ± 55.0)cc, (124.0 ± 12.4)Gy and (123.1 ± 12.6)Gy, (71.3 ± 13.7)Gy and (66.7 ± 13.5)Gy, (60.1 ± 7.5)% and (58.1 ± 7.8)%, (0.7296 ± 0.0702) and (0.7476 ± 0.0748), (24.6 ± 12.8)% and (21.8 ± 13.6)%, (34.4 ± 7.9)% and (36.5 ± 7.8)%, respectively, with a statistically significant difference. No statistically significant differences were observed in post-operative PTV and dosimetric parameters between the two groups except for D. For the experimental group, the median value of D was 126.27 Gy, and corresponding values were 121.63 Gy for the control group (p < 0.05).
The modified 3DPNCT improved consistency between pre- and post-operative dose parameters in comparison to the conventional 3DPNCT and showed the potential to deliver a higher dose to the tumor. This innovative 3DPNCT provides enhanced adaptability for intraoperative needle adjustments during seed implantation therapies.
Not applicable.
本研究比较了改良型三维打印非共面模板（3DPNCT）与传统3DPNCT在恶性肿瘤碘-125（I）粒子植入中的应用效果，并分析了相关技术差异。
我们分析了2021年2月至2023年5月在我科接受I粒子植入的恶性肿瘤患者。使用改良3DPNCT引导的病例组成实验组，使用传统3DPNCT的病例组成对照组。所有患者均接受相同的计算机断层扫描（CT）、术前规划和三维打印模板创建方案。实验组具有可调节的导针柱，可在术中调整针的角度/方向。比较组内和组间术前和术后的计划靶体积（PTV）以及剂量学参数，包括D、D、V、V、适形指数（CI）、外扩指数（EI）和均匀性指数（HI）。
共纳入70例患者，其中实验组35例，对照组35例。实验组术前和术后的PTV、D、CI和EI值分别为61.4(24.9,106.6)cc和61.6(24.9,106.7)cc、(71.9±16.77)Gy和(65.6±18.0)Gy、0.7615(0.7102,0.7941)和0.7780(0.7214,0.8172)、19.0(14.8,25.6)%和16.1(13.0,28.0)%，差异有统计学意义（P<0.05）。对照组术前和术后的PTV、D、D、V、CI、EI和HI值分别为(69.0±55.0)cc和(69.1±55.0)cc、(124.0±12.4)Gy和(123.1±12.6)Gy、(71.3±13.7)Gy和(66.7±13.5)Gy、(60.1±7.5)%和(58.1±7.8)%、(0.7296±0.0702)和(0.7476±0.0748)、(24.6±12.8)%和(21.8±13.6)%、(34.4±7.9)%和(36.5±7.8)%，差异有统计学意义。除D外，两组术后PTV和剂量学参数无统计学差异。实验组D的中位数为126.27 Gy，对照组为121.63 Gy（p<0.05）。
与传统3DPNCT相比，改良型3DPNCT提高了术前和术后剂量参数的一致性，并显示出向肿瘤输送更高剂量的潜力。这种创新的3DPNCT在粒子植入治疗过程中为术中针的调整提供了更强的适应性。
不适用。
