The use of the multislice CT for the determination of respiratory lung tumor movement in stereotactic single-dose irradiation
The use of the multislice CT for the determination of respiratory lung tumor movement in stereotactic single-dose irradiation
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DOI：
10.1007/s00066-003-1070-8
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发表时间：
2003-08-01
影响因子：
3.1
通讯作者：
Debus, J
中科院分区：
文献类型：
--
作者：
Hof, H;Herfarth, KK;Debus, J
背景资料：在肺部肿瘤的三维高剂量精确放射治疗中，计划靶区（PTV）的精确确定是必不可少的。因此，通过使用一个multislice CT scanner.Patients和方法：20个连续治疗的患者21个肺肿瘤的呼吸运动的3-D测定呼吸肺肿瘤运动的可行性进行了研究。14例患者使用腹压装置减少呼吸运动。在相同的扫描床位置重复扫描肿瘤的两个区域，每个周期显示四个同时采集的切片。为每个肿瘤区域的一个解剖参考点确定立体定位坐标（图1）。评估连续获得的循环之间这些坐标的3-D差异（图2），并进行与肿瘤定位的相关性。结果：在颅尾（Z-）方向上，平均肿瘤移动为5.1 mm（标准差[SD] 2.4 mm，最大值10 mm），腹背（Y-）方向3.1 mm（SD 1.5 mm，最大6.7 mm），横向（X-）方向为2.6 mm（SD 1.4 mm，最大5.8 mm;图3至图5）。个体间和个体内差异存在于每个方向。与腹部压力装置没有临床显着差异肿瘤在不同Locations.Conclusion：3-D评估肺肿瘤运动由于呼吸是可能的，通过使用多层螺旋CT。由于检测到的个体间和个体内偏差，对PTV定义必不可少的测定应针对多个区域单独进行。
Background: In three-dimensional (3-D) precision high-dose radiation therapy of Lung tumors, the exact definition of the planning target volume (PTV) is indispensable. Therefore, the feasibility of a 3-D determination of respiratory Lung tumor movements by the use of a muttislice CT scanner was investigated.Patients and Methods: The respiratory motion of 21 Lung tumors in 20 consecutively treated patients was examined. An abdominal pressure device for the reduction of respiratory movement was used in 14 patients. Two regions of the tumor were each scanned repeatedly at the same table position, showing four simultaneously acquired slices for each cycle. Stereotactic coordinates were determined for one anatomic reference point in each tumor region (Figure 1). The 3-D differences of these coordinates between the sequentially obtained cycles were assessed (Figure 2), and a correlation with the tumor Localization was performed.Results: In the craniocaudal (Z-)direction the mean tumor movement was 5.1 mm (standard deviation [SD] 2.4 mm, maximum 10 mm), in the ventrodorsal (Y-)direction 3.1 mm (SD 1.5 mm, maximum 6.7 mm), and in the lateral (X-)direction 2.6 mm (SD 1.4 mm, maximum 5.8 mm; Figures 3 to 5). Inter- and intraindividual differences were present in each direction. With an abdominal pressure device no clinically significant difference between tumors in different Locations was seen.Conclusion: The 3-D assessment of Lung tumor movements due to breathing is possible by the use of multislice CT. The determination, indispensable to the PTV definition, should be performed individually for several regions, because of the inter- and intraindividual deviations detected.