摘要
目的:基于锥形束CT(CBCT)对乳腺癌放疗两种不同的定位方式做图像引导,综合分析每次治疗前CBCT图像配准后获得的左右、头脚、腹背、俯仰、旋转、侧倾等6个方向的摆位误差,为临床应用提供参考。方法:选取2021年1月—2023年12月接受容积调强放疗技术的120例乳腺癌术后放疗患者为研究对象,经随机数字表法分为A组(n=60)和B组(n=60)。A组予以传统乳腺癌托架定位方式进行固定,B组予以基于CIVCO乳腺托架平角放置负压垫的定位方式。通过CBCT在放疗前进行图像引导和摆位调整,记录并分析左右、头脚、腹背、俯仰、旋转和侧倾方向的摆位误差。结果:根据两组病例CBCT 320次的移床数据分析,计算误差平均值及标准差发现,两组摆位误差均能较好满足位置精度要求。B组垂直平移(Vrt)、横向平移(Lat)、旋转角度(Rtn)、俯仰旋转(Pitch)、头脚旋转(Roll) 与A组比较,差异无统计学意义(P>0.05);B组纵向平移(Lng)低于A组,差异有统计学意义(P<0.05)。结论:基于CIVCO乳腺托架采用平角放置负压垫的定位方式优于托架底部和患者背部呈25°~30°夹角的定位方式。
Objective To perform image guidance for two difffferent localization methods of breast cancer radiotherapy using cone beam computed tomography(CBCT)and comprehensively analyze the setup errors in six directions(left-right,head-foot,anteriorposterior,pitch,rotation,roll)obtained from CBCT image registration before each treatment session,providing a reference for clinical applications.Methods A total of 120 post-operative breast cancer patients who underwent intensity-modulated radiotherapy(IMRT)between January 2021 and December 2023 were selected as the study subjects.They were randomly divided into two groups:Group A(n=60),which was fifixed using the traditional breast bracket localization method,and Group B(n=60),which was fifixed using the breast bracket based on the CIVCO in a flflat position with a vacuum cushion.Image guidance and setup adjustments were performed using CBCT before radiotherapy,and the setup errors in six directions(left-right,head-foot,anterior-posterior,pitch,rotation,and roll)were recorded and analyzed.Results Based on the analysis of 320 couch movement data points from the two groups,the mean and standard deviation of setup errors showed that the errors in both groups met the positional accuracy requirements.There was no statistically signifificant difffference between Group A and Group B in terms of vertical translation(Vrt),lateral translation(Lat),rotation angle(Rtn),pitch rotation(Pitch),and roll rotation(Roll)(P>0.05).However,longitudinal translation(Lng)in Group B was signifificantly lower than in Group A(P<0.05).Conclusions The flflat positioning method using a vacuum cushion on the CIVCO breast bracket is superior to the method where the bottom of the bracket forms a 25°-30°angle with the patient's back.
作者
倪昭聪
尚玉芬
NI Zhaocong;SHANG Yufen(Department of Radiation Physics Technology,Dezhou Second People's Hospital,Dezhou,Shandong 253000,China)
出处
《影像研究与医学应用》
2025年第10期44-46,49,共4页
Journal of Imaging Research and Medical Applications
关键词
锥形束CT
乳腺癌
放疗
定位方式
Cone-beam CT
Breast cancer
Radiotherapy
Localization method
