局部晚期宫颈癌三维适形近距离放疗CT与MRI定位的对比研究

被引：23

作者：

朱永刚

赵红福

程光惠

何明远

施丹

赵志鹏

机构：

[1] 长春,吉林大学中日联谊医院放疗科

来源：

中华放射肿瘤学杂志 | 2015年 / 24卷 / 04期

关键词：

宫颈肿瘤; 图像引导近距离放射疗法; 靶区勾画; 剂量学;

D O I：

暂无

中图分类号：

R737.33 [子宫肿瘤]; R730.55 [放射疗法];

学科分类号：

100105 ;

摘要：

目的比较CT与MRI图像引导的局部晚期宫颈癌三维适形近距离放疗靶区及剂量学的差异, 为优化影像引导方式及改进治疗方案提供依据。方法 2014年本院行宫颈癌根治性放疗的局部晚期患者13例, 均行外照射+MRI引导三维适形腔内+插植近距离治疗。每次后装均实施MRI和CT扫描, 并分别进行靶区勾画、腔内+插植和模拟去除插植针单纯腔内治疗计划设计。对两组扫描数据进行配对t检验。结果 MRI比CT的高危CTV的宽度、体积小[(38.0±9.4)mm :(45.1± 8.7)mm(P=0. 000)、(34.2±15. 3)cm3 : 42.9±20. 4 cm3(P=0. 002)], 中危CTV的宽度、厚度、体积也小[(58.8±9.4)mm :(65.4±10.3)mm(P=0. 000)、(34.8± 6. 3)mm :(37.5±6.3)mm(P= 0.001)、(90.9土28. 5)cm3 :(109.0±36. 4)cm3(P=0. 000)]。MRI较CT的高危、中危CTV的D90%均增高[87.6Gy :85. 8 Gy(P=0.013)、67.7 Gy :66. 3 Gy(P=0. 005)], 而膀胱、直肠D2cm3均降低[73. 1 Gy :75. 5 Gy(P=0.011)、61. 0 Gy :65. 7 Gy(P=0. 000)]。结论 CT比MRI定位过度评估靶区宽度;应用MRI定位靶区和正常组织剂量有明显优势;腔内+插植可弥补CT引导造成的靶区剂量下降。

引用

页码：408 / 413

页数：6

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