栏目: 技术与方法

摘要
• 摘要:   目的  研究胸部肿瘤患者进行放射治疗时，使用4D 锥形束CT（CBCT）作为图像引导策略，选用自动配准方式进行图像配准，分析其针对胸部不同种类肺部肿瘤的精度，为临床使用4D CBCT提供指导。  方法  使用呼吸运动模体及两种肺插件模拟胸部两种肿瘤（肺内孤立性肿瘤和粘连性肿瘤）及其运动，对每种模拟肿瘤扫描4D CT，在各种人为摆位误差下扫描4D CBCT，使用手动和自动配准方式对各组4D CBCT进行配准。  结果  肺内粘连性肿瘤组出现较多明显误配情况，以靶区大小创建蒙片及靶区外扩0.5 cm创建蒙片的自动配准方式与手动配准方式结果差异有统计学意义；肺内孤立性肿瘤组明显误配情况偶发，各种自动配准方式与手动配准方式结果差异均无统计学意义。  结论  在使用4D CBCT作为胸部肿瘤患者图像引导策略时，对于与胸壁、纵隔等粘连的肿瘤不宜使用其自动配准程序；对于肺内孤立性肿瘤，自动配准方式与手动配准方式具有相似的配准精度，但仍需审核排除明显误配的情况。

  关键词:
  • 4D CBCT / 
  • 自动配准算法 / 
  • 配准误差 / 
  • 摆位误差 
  Abstract:   Objective  In order to provide guidance for clinical use of four-dimensional cone-beam CT (4D CBCT), the accuracy of image registration and its influencing factors were analyzed using the automatic registration method when 4D CBCT was used as an image guidance strategy for patients with chest tumors.  Methods  The respiratory motion model and two kinds of lung plug-ins were used to simulate two types of tumors and their movements in the chest. 4D CT was scanned for each kind of simulated tumor, and 4D CBCT was scanned under various artificial positioning errors. For the registration of 4D CBCT, the manual and automatic registration methods were used for each group.  Results  There were more obvious mismatches in the intrapulmonary adhesion tumor group. When the masks were created based on the size of the target area or expanding the target area by 0.5 cm, the results between the automatic registration and manual registration were statistically different. There were no significant mismatches in the isolated lung tumor group, and there was no statistical difference between the results of automatic registration and manual registration.  Conclusions  When 4D CBCT is used as an image guidance strategy for patients with chest tumors, the automatic registration procedure should not be used for tumors adhering to chest wall and mediastinum. For solitary lung tumors, the automatic registration method and the manual registration method have similar registration accuracy, but significant mismatches need to be excluded.

  Key words:
  • 4D CBCT / 
  • Automatic registration algorithm / 
  • Registration error / 
  • Setup error 
HTML全文
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  图  1  4D CBCT自动配准误结果展示

  Figure  1.  The results of 4D CBCT automatic registration error

  A: The result of a correct automatic registration; B: The result of an obvious error automatic registration.

  下载: 全尺寸图片 幻灯片
  

  图  2  4D CBCT配准误差与人为摆位误差的关系

  Figure  2.  The relationship between the registration error of 4D CBCT and the artificial positioning error

  The first row shows the group of adherent tumors, and the second row shows the group of isolated tumors. Subgraphs from left to right represent SI, AP, and LR directional registration errors, respectively.

  下载: 全尺寸图片 幻灯片

  表  1  各种配准方式下，两种肿瘤的4D CBCT配准误差

  Table  1.   The mean and standard deviation of 4D CBCT registration errors for various registration methods

  Registration method	Group A				Group B
  	SI/cm	AP/cm	LR/cm		SI/cm	AP/cm	LR/cm
  Magv	0.07±0.08	0.01±0.01	0.1±0.08		0.05±0.04	0.06±0.05	0.06±0.03
  Mall	0.06±0.03	0.05±0.04	0.09±0.08		0.04±0.03	0.06±0.05	0.08±0.02
  Aclip	0.28±0.37	0.05±0.05	0.03±0.02		0.04±0.03	0.06±0.03	0.07±0.01
  Amask+0	1.74±1.24*	0.84±0.46*	0.36±0.49		0.06±0.08	0.05±0.03	0.09±0.01
  Amask+0.5	0.71±0.32*	1.02±0.86*	0.83±0.99		0.04±0.02	0.06±0.03	0.08±0.00
  Amask+1	0.96±0.02*	0.08±0.06	0.06±0.07		0.04±0.02	0.05±0.03	0.07±0.01
  Amask+1.5	1.02±0.14*	0.08±0.07	0.06±0.06		0.05±0.04	0.05±0.03	0.07±0.00
  Group A: The intrapulmonary adhesion tumor group; Group B: The solitary lung tumor group. * P<0.05, vs. magv, mall, aclip.

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