Automated functional image-guided radiation treatment planning for rectal cancer
Automated functional image-guided radiation treatment planning for rectal cancer
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DOI：
10.1016/j.ijrobp.2004.12.089
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发表时间：
2005-07-01
影响因子：
7
通讯作者：
Szekely, G
中科院分区：
文献类型：
--
作者：
Ciernik, IF;Huser, M;Szekely, G
目的：基于计算机断层扫描（CT）的肿瘤体积定义是耗时的，并受到临床解释。CT无法用于治疗体积计划的标准化算法。我们已经评估了目标体积定义的准确性的基础上，正电子发射断层扫描（PET）的数据从一个集成的PET/CT系统与2-[F-18]氟-2-脱氧-D-葡萄糖（FDG）标准化的目标体积delineation.Materials和方法：11例直肠癌患者进行术前放射治疗（RT）进行了研究。测试标准化区域生长算法以用PET衍生的大体肿瘤体积（PET-GTV）或生物靶体积（BTV）替换CT衍生的大体肿瘤体积。开发了一种软件工具来自动描绘由FDG信号、PET-GTV和计划靶体积（PTV）定义的适当肿瘤体积。PET衍生的体积进行了比较，从CT.Results的目标体积：BTV定义为适当的GTV评估设置在一个单一的峰值阈值的40%的信号感兴趣。基于选择单个肿瘤体积衍生PET体素的即刻治疗体积定义导致肿瘤体积与CT衍生GTV（r（2）= 0.84; p < 0.01）和随后解剖病理分析评估的体积（r（2）= 0.77; p < 0.01）密切相关。在分别从CT衍生的GTV和PET衍生的GTV到PTV提供足够的扩展边界时，CT衍生的PTV和PET衍生的PTV的相关性对于外部射束治疗的PTV定义是足够准确的（r（2）= 0.96; p < 0.01）。来自直肠癌的PET信号的自动分割可以允许用于术前检查的初步工作PTV的立即和足够准确的定义。如果需要，可以在第二步中应用解剖精度和几何分辨率的校正。计算PET为基础的目标体积的定义可能是有用的定义标准化的同时内部增强体积的调强放射治疗（IMRT）的基础上生物靶体积。(c)2005年爱思唯尔公司
Purpose: Computer tomography-based (CT-based) tumor-volume definition is time consuming and is subject to clinical interpretation. CT is not accessible for standardized algorithms for the purpose of treatment-volume planning. We have evaluated the accuracy of target-volume definition based on the positron emission tomography (PET) data from an integrated PET/CT system with 2-[F-18]fluoro-2-deoxy-D-glucose (FDG) for standardized target-volume delineation.Materials and Methods: Eleven patients with rectal cancer who were undergoing preoperative radiation therapy (RT) were studied. A standardized region-growing algorithm was tested to replace the CT-derived gross tumor volume by the PET-derived gross tumor volume (PET-GTV) or the biologic target volume (BTV). A software tool was developed to automatically delineate the appropriate tumor volume as defined by the FDG signal, the PET-GTV, and the planning target volume (PTV). The PET-derived volumes were compared with the target volumes from CT.Results: The BTV defined for appropriate GTV assessment was set at a single peak threshold of 40% of the signal of interest. Immediate treatment volume definition based on the choice of a single-tumor volume-derived PET-voxel resulted in a tumor volume that strongly correlated with the CT-derived GTV (r(2) = 0.84; p < 0.01) and the volume as assessed on subsequent anatomic-pathologic analysis (r(2) = 0.77; p < 0.01). In providing sufficient extension margins from the CT-derived GTV and the PET-derived GTV, to PTV, respectively, the correlation of the CT-derived and PET-derived PTV was sufficiently accurate for PTV definition for external-beam therapy (r(2) = 0.96; p < 0.01).Conclusion: Automated segmentation of the PET signal from rectal cancer may allow immediate and sufficiently accurate definition of a preliminary working PTV for preoperative RT. If required, correction for anatomic precision and geometric resolution may be applied in a second step. Computed PET-based target-volume definition could be useful for the definition of standardized simultaneous internal-boost volumes for intensity-modulated radiation therapy (IMRT) based on biologic target volumes. (c) 2005 Elsevier Inc.