Analysis of prostate and seminal vesicle motion: Implications for treatment planning
Analysis of prostate and seminal vesicle motion: Implications for treatment planning
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DOI：
10.1016/0360-3016(95)02081-0
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发表时间：
1996-01-15
影响因子：
7
通讯作者：
Coleman, CN
中科院分区：
文献类型：
--
作者：
Beard, CJ;Kijewski, P;Coleman, CN
目的：量化前列腺和精囊位置变化（目标运动）之间的治疗计划和交付，并确定因素对目标运动的贡献。30例前列腺癌患者通过分析两次连续计划计算机断层扫描（CT）扫描进行了前瞻性评价（S-1，治疗前获得，S-2在治疗第4周期间获得）。所有感兴趣的解剖体积（软组织和骨）从横向CT图像重建，并投影到前和侧梁的眼睛视图投影。通过应用刚体平移和旋转消除了S-1和S-2之间的位置变化。然后通过记录边缘（右、左、上级、下级）S-1和S-2之间的位置变化来测量靶运动。潜在的相关性的目标运动与膀胱容量，直肠容量，直肠直径的变化进行了评估，通过线性回归analysis.Results：无论是前列腺，也不是精囊保持固定相对于骨解剖之间的S-1和S-2。位置变化的分布通常较小（< 0.5 cm），但确实发生了1.5-2.2 cm的最大位移，特别是在侧位片中。在这项研究中，扫描之间的膀胱体积变化很小，与靶运动无关（p = 0.67）。直肠体积和直肠直径变化均与前列腺（分别为p = 0.004和0.005）和精囊（分别为p < 0.001和< 0.001）的目标运动相关。然而，无论是初始直肠体积，也不是初始直肠直径可以用来预测随后的目标运动时，单独评估或作为一个多元回归model.Conclusions的一部分：目标运动发生在治疗计划和交付的过程中，应考虑设计适形辐射场。尽管在规划CT时的靶位置可能与平均治疗位置有很大不同，但不能通过评估单次扫描或双次扫描序列的简单测量参数来预测靶运动。
Purpose: To quantify prostate and seminal vesicle positional changes (target motion) between treatment planning and delivery, and to identify the factors contributing to target motion.Methods and Materials: Thirty patients with adenocarcinoma of the prostate were prospectively evaluated by analyzing two sequential planning computerized tomography (CT) scans (S-1, obtained prior to treatment, and S-2 obtained during the fourth week of treatment) for each patient. All anatomical volumes of interest (soft tissue and bony) were reconstructed from transverse CT images and projected onto anterior and lateral beam's-eye view projections. Positional changes between S-1 and S-2 were eliminated by applying a rigid body translation and rotation. Target motion was then measured by recording the positional change between S-1 and S-2 at the edges (right, left, superior, inferior). Potential correlation of target motion with bladder volume, rectal volume, and rectal diameter changes were evaluated by linear regression analysis.Results: Neither the prostate nor seminal vesicles remained fixed with respect to bony anatomy between S-1 and S-2. The distribution of positional changes were generally small (< 0.5 cm), but maximum displacements of 1.5-2.2 cm did occur, particularly in the lateral view. In this study, bladder volume changes between the scans were small and did not correlate with target motion (p = 0.67). Both rectal volume and rectal diameter changes correlated with target motion for both the prostate (p = 0.004 and 0.005, respectively) and seminal vesicles (p < 0.001 and < 0.001, respectively). However, neither the initial rectal volume nor the initial rectal diameter could be used to predict subsequent target motion when evaluated either singly or as part of a multiple regression model.Conclusions: Target motion occurs during the course of treatment planning and delivery and should be considered when designing conformal radiation fields. Although the target position at the time of planning CT may differ substantially from the mean treatment position, target motion cannot be predicted by evaluating simply measured parameters from a single scan, or double scan sequence.