The incorporation of SPECT functional lung imaging into inverse radiotherapy planning for non-small cell lung cancer
The incorporation of SPECT functional lung imaging into inverse radiotherapy planning for non-small cell lung cancer
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DOI：
10.1016/j.radonc.2005.08.008
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发表时间：
2005-12-01
影响因子：
5.7
通讯作者：
Brada, M
中科院分区：
文献类型：
--
作者：
Christian, JA;Partridge, M;Brada, M
背景与目的：非小细胞肺癌（NSCLC）患者通常存在肺灌注不均匀。放射治疗计划计算机断层扫描 (CT) 扫描已与肺灌注单光子发射计算机断层扫描 (SPECT) 扫描准确地共同配准，以设计限制健康“灌注”肺部剂量的放疗治疗。 患者和方法：局部 NSCLC 患者的 CT 和 SPECT 扫描在计划系统中准确地共同配准。 SPECT 图像用于定义灌注“功能”肺 (FL) 的体积。使用逆向计划软件创建 3D 适形计划，计划目标是最大限度地减少全肺 (WL) 的剂量或最大限度地减少 FL 的剂量。结果：为六名患者中的每人创建了四个计划。 WL 和 FL 之间的平均体积差异为 1011.7 cm(3)（范围 596.2-1581.1 cm(3)）。一名双侧上叶灌注不足的患者的 FLV20（接受 >= 20 Gy 的功能肺体积百分比）降低了 16%。其余患者存在不均匀的灌注缺陷，因此逆向计划无法充分优化射束角度以避免肺功能正常。结论：SPECT 灌注图像可以与放疗计划 CT 扫描准确地共同配准，可能有助于为存在严重灌注缺陷的患者制定治疗计划。 (c) 2005 Elsevier Ireland Ltd. 保留所有权利。放射治疗和肿瘤学 77 (2005) 271-277。
Background and purpose: Patients with non-small cell lung cancer (NSCLC) often have inhomogeneous lung perfusion. Radiotherapy planning computed tomography (CT) scans have been accurately co-registered with lung perfusion single photon emission computed tomography (SPECT) scans to design radiotherapy treatments which limit dose to healthy 'perfused' lung.Patients and methods: Patients with localised NSCLC had CT and SPECT scans accurately co-registered in the planning system. The SPECT images were used to define a volume of perfused 'functioning' lung (FL). Inverse planning software was used to create 3D-conformal plans, the planning objective being either to minimise the dose to whole lungs (WL) or to minimise the dose to FL.Results: Four plans were created for each of six patients. The mean difference in volume between WL and FL was 1011.7 cm(3) (range 596.2-1581.1 cm(3)). One patient with bilateral upper lobe perfusion deficits had a 16% reduction in FLV20 (the percentage volume of functioning lung receiving >= 20 Gy). The remaining patients had inhomogeneous perfusion deficits such that inverse planning was not able to sufficiently optimise beam angles to avoid functioning lung.Conclusion: SPECT perfusion images can be accurately co-registered with radiotherapy planning CT scans and may be helpful in creating treatment plans for patients with large perfusion deficits. (c) 2005 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 77 (2005) 271-277.