Preliminary results of a new workflow for MRI/CT-based image-guided brachytherapy in cervical carcinoma
Preliminary results of a new workflow for MRI/CT-based image-guided brachytherapy in cervical carcinoma
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DOI：
10.1007/s11604-017-0690-3
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发表时间：
2017-12-01
影响因子：
2.1
通讯作者：
Uno, Takashi
中科院分区：
文献类型：
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作者：
Nemoto, Miho Watanabe;Iwai, Yuma;Uno, Takashi
我们提出了一种图像引导的近距离放射治疗（IGBT）的方法，结合MRI为基础的目标体积划定的第一部分与CT数据集的后续分数，使用自动，基于应用程序的共注册，并报告我们的初步经验。对于每个后续近距离放射治疗部分，在相同的施源器插入后，获得施源器就位的新CT扫描。使用用于刚体配准的施源器将MR图像集配准到后续近距离放射治疗计划CT。为了证明配准质量，我们在此使用Dice指数作为CT和MRI之间串联描绘重叠的测量，Dice指数的中位数为0.879（范围为0.610-0.932），这表明CT和MRI上的轮廓拟合良好。采用这种组合方法，HR CTV的中位数D90和计算的每个部分中膀胱、直肠和乙状结肠的D2 cm 3为7.2（4.0-10.4）、5.9（2.3-7.7）、4.0（1.9-6.7）和3.8（0.6-7.2）戈伊。
We propose a method of image-guided brachytherapy (IGBT) that combines MRI-based target volume delineation for the first fraction with CT datasets of subsequent fractions, using an automatic, applicator-based co-registration, and report our preliminary experience.The MRI of the first fraction was used for the first brachytherapy planning. For each subsequent brachytherapy fraction, after the same applicator insertion, a new CT scan with the applicator in place was obtained. The MR image set was registered to the subsequent brachytherapy treatment planning CT using the applicator for rigid body registration. To demonstrate the registration quality, we used here the Dice index as a measurement of tandem delineation overlap between CT and MRI.The median Dice index was 0.879 (range 0.610-0.932), which indicated that the contours on CT and MRI fitted well. With this combination method, the median D90 of HR CTV and the calculated D2 cm(3) of the bladder, rectum, and sigmoid in each fraction were 7.2 (4.0-10.4), 5.9 (2.3-7.7), 4.0 (1.9-6.7), and 3.8 (0.6-7.2) Gy, respectively.Our described method of MRI-guided IGBT offers a practical option for the benefits of target delineation.