Comparative study for CT-guided 125I seed implantation assisted by 3D printing coplanar and non-coplanar template in peripheral lung cancer
Comparative study for CT-guided 125I seed implantation assisted by 3D printing coplanar and non-coplanar template in peripheral lung cancer
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DOI：
10.5114/jcb.2019.84503
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发表时间：
2019-01-01
影响因子：
1.4
通讯作者：
Wang, Junjie
中科院分区：
文献类型：
--
作者：
Ji, Zhe;Sun, Haitao;Wang, Junjie
目的：我们比较了三维打印非共面模板（3DPNCT）计划和三维打印共面模板（3DPCT）计划在肺癌放射性粒子植入（RSI）中的应用，并探讨了两种技术之间的差异。材料和方法：对2017年6月至2018年2月在我科接受3DPCT辅助RSI的33例周围型肺癌患者进行分析。为所有患者重新设计了3DPNCT计划。新计划中的处方剂量和种子活性与3DPCT计划相同。比较两个计划中的数据，包括种子数量、针数量、穿过肋骨所需的针数量和剂量学参数。剂量学参数包括靶体积的D-90、D-均值、MPD（最小外周剂量）、V-100、V-150、CI（符合性指数）、EI（外部指数）、HI（均匀性指数）、脊髓和主动脉的D-2cc以及患侧肺的V-20。我们使用配对t检验和两组相关的非参数检验来检验统计学意义。结果：除MPD外，其他剂量学参数均无显著性差异（p > 0.05）。3DPNCT计划的平均MPD显著高于3DPCT计划（分别为88.5戈伊和81.8戈伊，p = 0.017）。与3DPCT计划相比，3DPNCT计划中使用的针数和穿过肋骨所需的针数显著减少（p = 0.000）。结论：两种3DPCT计划的剂量分布相似。3DPNCT计划在靶区边缘的剂量更高，针数更少，肋骨断裂更少。
Purpose: We compared the three-dimensional printed non-coplanar template (3DPNCT) plans with 3D-printed coplanar template (3DPCT) plans for radioactive seed implantation (RSI) in lung cancer and explored the differences between the two technologies.Material and methods: 33 patients with peripheral lung cancer that received 3DPCT-assisted RSI in our department between June 2017 and February 2018 were analyzed. A 3DPNCT plan was re-designed for all patients. The prescribed dose and seed activity in the new plan were the same as the 3DPCT plan. The data in the two plans were compared, including seed number, needle number, number of needles needed to cross the ribs, and dosimetry parameters. Dosimetry parameters included D-90, D-mean, MPD (minimum peripheral dose), V-100, V-150, CI (conformity index), EI (external index), HI (homogeneity index) of target volume, D-2cc of spinal cord and aorta, and V-20 of affected side lung. We used a paired t-test and two groups of related non-parameters tests to examine statistical significance. A p value < 0.05 was considered statistically significant.Results: We found no significant difference in dosimetry parameters (p > 0.05), except MPD. The mean MPD of the 3DPNCT plan was significantly higher than the 3DPCT plan (88.5 Gy and 81.8 Gy, respectively, p = 0.017). The number of needles used in the 3DPNCT plan and the number of needles needed to cross the ribs were significantly less compared with the 3DPCT plan (p = 0.000).Conclusions: The dose distributions of the two 3DPCT plans were similar. 3DPNCT plan had a higher dose in target volume margin, with fewer needles and fewer breaks to the ribs.