摘要
目的通过剂量学分析,探讨3D打印非共面模板(3D-PNCT)辅助CT引导下125 I粒子植入的临床应用价值。方法对15例患者行3D-PNCT辅助CT引导下125 I粒子植入治疗。通过CT模拟定位设备行体位固定及复位。术前制定计划并行3D-PNCT打印,复位后根据术前计划植入粒子,术后进行剂量学验证。比较术前预估与术后实测剂量学指标,包括90%靶区体积剂量(D 90)、100%靶区体积剂量(D 100)、90%处方剂量体积百分比(V 90)、100%处方剂量体积百分比(V 100)及150%处方剂量体积百分比(V 150)的差异。结果对15例共18个病灶均顺利完成3D-PNCT辅助125 I粒子植入,平均复位时间(11.62±2.57)min。术后所测大体肿瘤靶区体积(GTV)明显大于术前[(64.25±50.16)cm^3 vs(57.37±44.25)cm^3;t=-3.163,P=0.006]。术后实际植入粒子数目明显多于术前预估[(46.39±24.18)枚vs(43.78±21.63)枚;t=-2.636,P=0.017];实测剂量学指标V 100及V 150值均明显低于术前预估(P均<0.05),而D 90、D 100及V 90与术前预估差异均无统计学意义(P均>0.05)。结论借助CT模拟定位设备可快速、精准完成3D-PNCT复位;3D-PNCT辅助CT引导下125 I粒子植入可较好地实现术前与术后主要剂量学指标匹配,精准植入粒子。
Objective To explore the application value of 3D-printing non-coplanar template(3D-PNCT)assisted CT-guided 125I seed implantation through dosimetry analysis.Methods A total of 15 patients underwent 3D-PNCT assisted CT-guided 125I seed implantation.Posture fixation and set-up were performed with CT-simulator devices.Before operation,pre-plan was carried out,and 3D-PNCT was printed.125I seeds were implanted into the lesions according to pre-plan after set-up and following postoperative verification.The dosimetric parameters,including doses of pre-plan and post-operation 90%,100%target volume(D 90,D 100)and volume percent of 90%,100%,150%prescribed doses(V 90,V 100,V 150)were compared.Results 3D-PNCT assisted CT-guided 125I seed implantation were successfully accomplished in 18 lesions of all 15 patients.The median time of 3D-PNCT set-up was(11.62±2.57)min.Post-operation gross tumor volume(GTV)was more than that in pre-plan([64.25±50.16]cm^3 vs[57.37±44.25]cm^3;t=-3.163,P=0.006).The number of implantated seeds were more than that in pre-plan(46.39±24.18 vs 43.78±21.63;t=-2.636,P=0.017).Post-operation V 100 and V 150 were less than those in pre-plan(both P<0.05).There was no significant difference of D 90,D 100 and V 90 between pre-plan and post-operation(all P>0.05).Conclusion 3D-PNCT set-up can be quickly and precisely accomplished using CT-simulator devices.3D-PNCT assisted CT-guided 125I seed implantation can accurately performed through well match of post-operation main dosimetric parameters with those in pre-plan.
作者
陈锦
林征宇
林清锋
严媛
林瑞祥
陈健
陈龙建
CHEN Jin;LIN Zhengyu;LIN Qingfeng;YAN Yuan;LIN Ruixiang;CHEN Jian;CHEN Longjian(Department of Intervention,the First Affiliated Hospital of Fujian Medical University,Fuzhou 350000,China;Department of Radiotherapy,the First Affiliated Hospital of Fujian Medical University,Fuzhou 350000,China)
出处
《中国介入影像与治疗学》
北大核心
2019年第10期590-594,共5页
Chinese Journal of Interventional Imaging and Therapy
关键词
三维打印
模板
粒子植入
碘同位素
辐射剂量
three dimensional printing
template
seed implantation
iodine isotopes
radiation dosage
